Mechanical circulatory support devices--state of the art.

Mechanical circulatory support devices (MCSDs) have been developed with the aim of bridging patients with advanced heart failure to cardiac transplantation, to recovery, and to serve as permanent support devices. The current generation of devices provides a differentiated spectrum of support, ranging from short-term to intermediate- and long-term duration, partial left ventricular (LV), complete LV, right ventricular, and biventricular options which can be tailored individually. The device positions range from paracorporeal to intracorporeal pumps with transcutaneous drivelines, to completely implantable systems. Major limitations are infection, coagulopathies, and device dysfunction. In this review, we discuss the history and experience with currently available MCSD options capable of supporting the circulation for 30 days.