To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?

While average survival in patients undergoing durable left ventricular assist device (dLVAD) support now approximate 6 years, the application of therapy remains limited across the globe. Herein we highlight important deficiencies common to present technology and propose device innovations and field...

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Main Authors: Jennifer A. Cowger, MD, MS, Evgenij Potapov, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:JHLT Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S295013342500120X
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author Jennifer A. Cowger, MD, MS
Evgenij Potapov, MD, PhD
author_facet Jennifer A. Cowger, MD, MS
Evgenij Potapov, MD, PhD
author_sort Jennifer A. Cowger, MD, MS
collection DOAJ
description While average survival in patients undergoing durable left ventricular assist device (dLVAD) support now approximate 6 years, the application of therapy remains limited across the globe. Herein we highlight important deficiencies common to present technology and propose device innovations and field corrections that will be necessary to improve acceptance of dLVAD support by both patients and medical providers caring for patients with end-stage heart failure. Pragmatic trials will also be needed to help identify the therapeutic strategy (permanent dLVAD support vs heart transplant vs dLVAD as a bridge to transplant) that affords the best outcomes for a patient’s risk profile and total survival goals.
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spelling doaj-art-63cc68629f6648df86101263fe2c304c2025-08-20T03:36:37ZengElsevierJHLT Open2950-13342025-08-01910032510.1016/j.jhlto.2025.100325To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?Jennifer A. Cowger, MD, MS0Evgenij Potapov, MD, PhD1Department of Cardiovascular Medicine, Henry Ford Health, Michigan State University and Wayne State University, Detroit, MI; Corresponding author: Jennifer Cowger, MD, MS, Associate Professor of Cardiovascular Medicine, Michigan State University and Wayne State University, Henry Ford Health, 2799 W Grand Blvd, K14, Detroit, MI 48202. Telephone: 734546 4911 (cell, do not publish). Telephone: 313 916-2966 (office admin). Fax: 313 916 8799.Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; German Centre for Cardiovascular Research, Partner Site Berlin, Berlin, GermanyWhile average survival in patients undergoing durable left ventricular assist device (dLVAD) support now approximate 6 years, the application of therapy remains limited across the globe. Herein we highlight important deficiencies common to present technology and propose device innovations and field corrections that will be necessary to improve acceptance of dLVAD support by both patients and medical providers caring for patients with end-stage heart failure. Pragmatic trials will also be needed to help identify the therapeutic strategy (permanent dLVAD support vs heart transplant vs dLVAD as a bridge to transplant) that affords the best outcomes for a patient’s risk profile and total survival goals.http://www.sciencedirect.com/science/article/pii/S295013342500120XLVADHeart failureHeart transplantOutcomesSurvivalAdverse events
spellingShingle Jennifer A. Cowger, MD, MS
Evgenij Potapov, MD, PhD
To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
JHLT Open
LVAD
Heart failure
Heart transplant
Outcomes
Survival
Adverse events
title To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
title_full To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
title_fullStr To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
title_full_unstemmed To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
title_short To build a better VAD: What is needed to make MCS truly competitive with cardiac transplantation for long-term outcomes?
title_sort to build a better vad what is needed to make mcs truly competitive with cardiac transplantation for long term outcomes
topic LVAD
Heart failure
Heart transplant
Outcomes
Survival
Adverse events
url http://www.sciencedirect.com/science/article/pii/S295013342500120X
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