Actual role of cardiocirculatory assistance in heart failure treatment

Patients with end-stage heart failure have poor quality of life and a poor prognosis. These patients are usually burdened by symptoms at rest, the need for frequent hospital admissions, complex pharmacological therapies and a 1-year mortality rate of about 50%. Therapeutic options are scarce and not available for all. Only few patients can be transplanted. Alternative medical and surgical therapies have shown limited ability to influence prognosis and quality of life. In the past years, technological progress has brought to the clinician mechanical devices capable of providing short/medium and long-term circulatory assistance. Clinical evidence of long-term survival without device-correlated adverse events using last generation small axial pumps, allows us to evaluate its use in patients with contraindications or inaccessibility to transplantation.