LVAD as destination therapy-the economic dilemma

The artificial heart, after decades of development, remains a long way off as a practical remedy for people with failing hearts. But a related technology, the left ventricular assist device (LVAD), has passed major milestones in its development and is poised for widespread use. This technology, which is an offshoot of the artificial heart program, may well have greater impact on society than the artificial heart. It is time to consider its probable costs to society. A heart transplant is the present treatment of choice for end-stage heart failure (ESHF).