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European Journal of Heart Failure 1999 1(4):319-325; doi:10.1016/S1388-9842(99)00033-1
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© 1999 European Society of Cardiology

Left ventricle assist systems: a possible alternative to heart transplantation for heart failure patients? Patient selection, techniques and benefit

Edoardo Gronda* and Ettore Vitali

Department of Cardiology and Cardiovascular Surgery ‘A. De Gasperis’, ‘Ca' Granda’ Hospital Milano-Niguarda, Italy

* Corresponding author, Programma Trapianto Cardiaco ed Insufficienza Cardiaca, Dipartimento ‘A. De Gasperis', Ospedale Niguarda-Ca’ Granda P.zza Ospedale Maggiore 3-20162 Milano, Italy. Tel.: +39-2-6444-2563; fax: +39-2-6444-2071 E-mail adderss: infodega@tin.it (E. Gronda)

Key Words: Left ventricle assist device • Congestive heart failure • Heart transplantation

Accepted June 25, 1999

The first 150 words of the full text of this article appear below.


   1. Background
 
According to a survey carried out in the USA based upon reviewing the diagnoses in 5.8 million patients discharged from 800 regional hospitals in 1991 [1], the cost of treating heart failure was more than $38 billion, more than cancer or acute myocardial infarction. In spite of an overall reduction in incidence, morbidity and mortality for cardiovascular disease the number of patients with a discharge diagnosis of heart failure in the USA has doubled, reaching 750 000 cases in 1990 [2,3]. The rising prevalence of heart failure probably reflects progressive ageing of the western population and the widespread application of both cardiological and surgical interventions that rescue patients from premature death but do not provide a definitive cure. Thus, it is not surprising that heart failure is diagnosed in approximately 2.5% of the whole population aged more than 45 years [4].

Heart failure is a . . . [Full Text of this Article]


   2. Mechanical cardiac assistance
 
2.1. Short-term/acute devices
2.2. Intermediate-term device
2.3. CardioWest Total Artificial Heart (TAH)
2.4. Long-term/permanent devices

   3. Patient selection
 

   4. NYHA Class IV patients: the targeted population for LVADs implantation
 

   5. Too sick to get benefit
 

   6. Experience at ‘Ca’Granda’ General Regional Hospital, Milano-Niguarda
 

   7. Bridge to recovery
 

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