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acute decompensated heart failure, bioimpedance, destination therapy, end-stage heart failure, left ventricular assist device, surgical options for advanced heart failure, ventricular assist device



  1. Cianci, Pamela RN, MSN, BC
  2. Lonergan-Thomas, Helen RN, BSN
  3. Slaughter, Mark MD
  4. Silver, Marc A. MD


The syndrome of heart failure is epidemic, causing increased hospital admissions, poor survival rates, and a dismal quality of life. Treatment choices include pharmacologic, psychological, and surgical interventions. Recent data suggest that mechanical heart pumps, or assist devices, are viable additions or alternatives to transplantation in management of advanced heart failure. A ventricular assist device (VAD) can support the circulation when the natural heart is unable to maintain adequate perfusion. Although its use continues to be explored, VADs can be used in three ways: as a bridge to transplantation, as a destination therapy (or implanted permanently), or as a bridge to recovery. As VAD science advances, nurses will needs to understand its practice implications.