CONCEIVING A PERCUTANEOUS LONG-TERM CARDIOCIRCULATORY ASSISTING DEVICE: A WORKING-HYPOTHESIS

Advances in mechanical support, the development of the left ventricular assist device (LVAD), and the total artificial heart have reduced mortality and morbidity in patients awaiting transplantation, and LVADs are now approved of as a strategy for destination therapy. Unfortunately, cardiac transplantation, LAVD and total artificial heart remain off limits for many different subsets of patients, such as those >65 years old, those with contraindications to heart transplantation or surgical device implantation requiring long-term support, and finally patients with contraindications to full anticoagulation.All these subsets of patients may benefit from a long-term endovascularly implanted support with low-anticoagulation therapy. The present work aims to evaluate whether is the current era a fully percutaneous LVAD assisting device for long-term assistance is at least theoretically conceivable: this process includes evaluation of the ideal features of such a device, its virtual design, the ideal implantation technique, the potential fields of use, and its eventual limitations.