Use of Ventricular Assist Devices and Heart Transplantation for Advanced Heart Failure

Leslie Miller, Emma Birks, Maya Guglin, Harveen Lamba, O. H. Frazier

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


There are only 2 treatments for the thousands of patients who progress to the most advanced form of heart failure despite the application of guideline-based medical therapy, use of ventricular assist devices and heart transplantation. There has been a great deal of progress in both of these therapies that have led to improved outcomes including significant improvement in survival and functional capacity. Heart transplantation offers the best short-and long-term survival for patients with end-stage heart failure, and the majority of these recipients achieve relatively limitless functional capacity for their age. However, the chronic shortage of available donors limits the number of recipients in the United States to an only 2500 patients/y or only a fraction of potential candidates. The significant improvement in outcomes now possible with durable ventricular assist devices has led to a significant increase in their use, which now exceeds the volume of heart transplants in the United States, with the greatest growth in use for those not considered to be candidates for heart transplantation, previously referred to as destination therapy. This article will review the substantial progress that has taken place for both of these life-saving treatment options, as well as the future directions.

Original languageEnglish
Pages (from-to)1658-1678
Number of pages21
JournalCirculation Research
Issue number11
StatePublished - May 24 2019

Bibliographical note

Publisher Copyright:
© 2019 American Heart Association, Inc.


  • cardiomyopathies
  • heart failure
  • mortality
  • survival
  • transplants

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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