Heart failure (HF) is a clinical condition characterized by typical symptoms (e.g. dyspnea, ankle swelling and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles and peripheral edema) due to a structural and/or functional cardiac abnormality, resulting in reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.1
HF is a life-threatening disease and addressing it should be considered a global health priority. At present, approximately 26 million people worldwide are living with heart failure. The outlook for such patients is poor, with survival rates worse than those for bowel, breast or prostate cancer,2 and the deterioration of heart failure is difficult to be reversed by existing drugs or traditional medical instruments. Heart transplant is known as one kind of treatments, but it fails to benefit the general public because of extremely limited heart donors. Mechanical Circulation Support (MCS) therapy, especially Ventricular Assist Devices (VAD), has gradually become an important treatment for end-stage heart failure patients. This novel, practical and accessible treatment can enable many individuals with advanced heart failure to lead longer and more comfortable lives.
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Currently, the number of patients with advanced heart failure is far greater than the number of donors available for heart transplants. Ventricular assist devices (VAD) not only save patients' lives, but also can possibly enable them to lead a normal life.
A ventricular assist device (VAD) is a mechatronics device, used as heart assist device to pump blood partly or totally in ventricular to ascending aorta, thus maintaining blood circulation of patients with heart failure. Its core component is a pump, pumping blood from the heart to the aorta after ascending blood pressure, to let natural heart rest by removing cardiac load, and address a natural heart’s insufficiency to pump blood.
After more than 50 years’ research and development in the United States and other developed countries, VAD was approved by FDA as an alternative treatment of heart transplant to treat severe heart failure in the early 21st Century. So far, nearly 100,000 cases of clinical use show that artificial heart can help patients with heart failure to improve quality of life significantly, prolong their lives, and even facilitate heart rehabilitation.
At present, a ventricular assist device (VAD) mainly has three clinical applications: one is to serve as a substitute for patients waiting for heart transplantation in the transition period, so they have more time to wait for suitable donors; The second is to provide short-term replacement support for patients with acute heart failure, it can be removed after the heart function is restored. The third is to provide long-term support for patients with end-stage heart failure. Long-term support therapy has become the mainstream clinical application of ventricular assist devices.
A VAD is a complex and sophisticated medical device, which has been developed from the first generation of pulsating flow VAD in the 1990s to the second generation of rotary assist device in the early 21st century. The fully magnetically levitated VAD as the newer generation product is characterized by magnetic levitation and bearingless, which has great clinical advantages of small size and good hemocompatibility.