Same bridge, new destinations rethinking paradigms for mechanical cardiac support in heart failure

Journal of the American College of Cardiology
G Michael Felker, Joseph G Rogers

Abstract

Mechanical cardiac support with ventricular assist devices is an established therapy for a variety of clinical scenarios, including postcardiotomy shock, "bridge to transplant," and "destination therapy." At present, device development, clinical trial design, regulatory approval, and reimbursement decisions for the clinical application of mechanical cardiac support devices continue to be considered in the context of these clinical indications. Although understandable from a historical perspective, these arbitrary divisions are inconsistent with the clinical realities of advanced heart failure therapy. By narrowly focusing on transplant eligibility at a static point in the clinical course, current guidelines impede the broader application of ventricular assist device technology to the growing population of patients who may benefit from this therapy.

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Citations

Jun 4, 2008·Current Opinion in Cardiology·Michael M Koerner, Jama Jahanyar
Jun 7, 2011·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Ralph J PetrucciJohn W Entwistle
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Sep 29, 2009·The Surgical Clinics of North America·Mani A Daneshmand, Carmelo A Milano

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