The Telltale Heart

This article describes features and functioning of left-ventricular assist devices (LVAD). LVADs are the fastest-growing category of mechanical heart devices and are the only category of mechanical heart-assist devices to be approved in the United States, Canada, and Europe as a commercially available treatment. The current generation of LVADs and implantable artificial hearts represent a major technological step. However, by all accounts, these devices have a long way to go before they are as mechanically sound and user-friendly as they need to be to be widely accepted as a destination therapy for more than just the sickest of the sick. Thoratec Corp., Pleasanton, CA, has received Food and Drug Administration approval of its HeartMate SnapVE LVAD and an updated model, the HeartMateXVE, for use as a long-term, permanent treatment for end-stage congestive heart failure patients who don't qualify for heart transplantation and have a life expectancy of less than two years. These devices, the best known of which is the Abiocor, from AbioMed of Danvers, Massachusetts, are still considered experimental.