{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T23:40:21Z","timestamp":1770162021307,"version":"3.49.0"},"reference-count":88,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Mechanical circulatory support (MCS) has revolutionized advanced heart failure and cardiogenic shock management, yet randomized controlled trials have failed to demonstrate consistent mortality benefits with temporary devices, and outcomes remain highly variable across institutions. Methods: This narrative review examines contemporary MCS devices, analyzing their hemodynamic principles, clinical outcomes, complications, and selection strategies. The published literature addressing MCS clinical applications and outcomes was reviewed, with reference lists examined to identify additional sources. Results: Temporary MCS devices demonstrate a persistent hemodynamic-survival paradox where improved hemodynamics fail to translate into mortality benefits in randomized trials. This disconnect reflects delayed intervention after irreversible organ damage, device complications offsetting hemodynamic gains, heterogeneous patient selection without phenotyping, timing challenges, and inadequate statistical power. Landmark trials provide definitive evidence against routine early VA-ECMO use, showing no survival advantage while significantly increasing complications. Optimal device selection requires integrating hemodynamic phenotyping with shock stage to match devices to pathophysiology, while biventricular failure presents the greatest challenge with substantially lower survival. For durable devices, third-generation systems demonstrate superior outcomes with dramatically reduced pump thrombosis and improved survival. Critically, multidisciplinary shock teams employing standardized protocols significantly reduce mortality beyond what devices alone achieve, with structured programs showing substantially improved survival compared to trials using similar devices without organized care systems. Conclusions: Mechanical circulatory support has transformed heart failure management, but optimal outcomes require integrating devices within structured care delivery systems. Success depends on comprehensive hemodynamic assessment, multidisciplinary team activation, protocolized device selection, standardized escalation and weaning strategies, and regionalized networks. The future lies in shifting focus from device innovation to implementation science, establishing quality metrics, developing precision medicine approaches, and conducting trials in phenotype-selected populations with protocolized care. This systems-of-care paradigm offers the most promising path toward translating technological advances into sustained mortality reduction.<\/jats:p>","DOI":"10.3390\/bioengineering13020177","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:03:29Z","timestamp":1770113009000},"page":"177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary Mechanical Support Devices for Temporary and Long-Term Applications"],"prefix":"10.3390","volume":"13","author":[{"given":"Sriharsha","family":"Talapaneni","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6972-8563","authenticated-orcid":false,"given":"Sair Ahmad","family":"Tabraiz","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghna","family":"Khandelwal","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreya","family":"Avilala","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8545-2964","authenticated-orcid":false,"given":"Shanzil","family":"Shafqat","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sedem","family":"Dankwa","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanseo","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4954-4685","authenticated-orcid":false,"given":"Irbaz","family":"Hameed","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: A comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.21037\/cdt-20-302","article-title":"Pathophysiology of heart failure","volume":"11","author":"Schwinger","year":"2021","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global Public Health Burden of Heart Failure","volume":"3","author":"Savarese","year":"2017","journal-title":"Card. Fail. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"C276","DOI":"10.1093\/eurheartjsupp\/suad027","article-title":"Acute heart failure: Differential diagnosis and treatment","volume":"25","author":"Marini","year":"2023","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_5","first-page":"16","article-title":"Contemporary Management of Cardiogenic Shock: A Scientific Statement from the American Heart Association","volume":"136","author":"Katz","year":"2017","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.cardfail.2024.01.011","article-title":"The Future of Durable Mechanical Circulatory Support: Emerging Technological Innovations and Considerations to Enable Evolution of the Field","volume":"30","author":"Dual","year":"2024","journal-title":"J. Card. Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102579","DOI":"10.1016\/j.cpcardiol.2024.102579","article-title":"Effectiveness of mechanical circulatory support devices in reversing pulmonary hypertension among heart transplant candidates: A systematic review","volume":"49","author":"Albulushi","year":"2024","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11906-017-0782-6","article-title":"The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities","volume":"19","author":"Castagna","year":"2017","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.healun.2015.10.003","article-title":"Seventh INTERMACS annual report: 15,000 patients and counting","volume":"34","author":"Kirklin","year":"2015","journal-title":"J. Heart Lung Transplant."},{"key":"ref_10","first-page":"454","article-title":"Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative","volume":"91","author":"Basir","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_11","first-page":"1173","article-title":"Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative","volume":"93","author":"Basir","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.jchf.2020.08.012","article-title":"Complete Hemodynamic Profiling with Pulmonary Artery Catheters in Cardiogenic Shock Is Associated with Lower In-Hospital Mortality","volume":"8","author":"Garan","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_13","first-page":"183","article-title":"Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: A document of the Acute Cardiovascular Care Association of the European Society of Cardiology","volume":"9","author":"Zeymer","year":"2020","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jacc.2004.03.060","article-title":"Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: A report from the SHOCK trial registry","volume":"44","author":"Fincke","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e007393","DOI":"10.1161\/CIRCHEARTFAILURE.120.007393","article-title":"Cardiac Power Output Revisited","volume":"13","author":"Lim","year":"2020","journal-title":"Circ. Heart Fail."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1161\/CIRCULATIONAHA.119.043080","article-title":"Value of Hemodynamic Monitoring in Patients with Cardiogenic Shock Undergoing Mechanical Circulatory Support","volume":"141","author":"Saxena","year":"2020","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/ejhf.1679","article-title":"Pulmonary artery pulsatility index: Physiological basis and clinical application","volume":"22","author":"Lim","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_18","first-page":"29","article-title":"SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019","volume":"94","author":"Baran","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Mehta, A., Vavilin, I., Nguyen, A.H., Batchelor, W.B., Blumer, V., Cilia, L., Dewanjee, A., Desai, M., Desai, S.S., and Flanagan, M.C. (2024). Contemporary approach to cardiogenic shock care: A state-of-the-art review. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1354158"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.cardfail.2017.10.009","article-title":"Right Ventricular Dysfunction in Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Hemodynamic Analysis of the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) Trial and Registry","volume":"24","author":"Lala","year":"2018","journal-title":"J. Card. Fail."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e019843","DOI":"10.1161\/JAHA.120.019843","article-title":"Right Heart Catheterization in Cardiogenic Shock Is Associated with Improved Outcomes: Insights from the Nationwide Readmissions Database","volume":"10","author":"Ranka","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.17925\/HI.2022.16.1.37","article-title":"A Comprehensive Review of Mechanical Circulatory Support Devices","volume":"16","author":"Atti","year":"2022","journal-title":"Heart Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"qyad011","DOI":"10.1093\/ehjimp\/qyad011","article-title":"Management of temporary mechanical circulatory support devices in cath-lab and cardiac intensive care unit","volume":"1","author":"Fortuni","year":"2023","journal-title":"Eur. Heart J. Imaging Methods Pract."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Xenitopoulou, M., Ziampa, K., Evangeliou, A., Tzikas, S., and Vassilikos, V. (2024). Percutaneous Mechanical Circulatory Support in Acute Heart Failure Complicated with Cardiogenic Shock. J. Clin. Med., 13.","DOI":"10.3390\/jcm13092642"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"829","DOI":"10.21037\/atm-20-2171","article-title":"Short-term mechanical circulatory support (intra-aortic balloon pump, Impella, extracorporeal membrane oxygenation, TandemHeart): A review","volume":"8","author":"Wong","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"91","DOI":"10.12703\/P6-91","article-title":"Mechanical circulatory support in acute cardiogenic shock","volume":"6","author":"Khan","year":"2014","journal-title":"F1000Prime Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/eurheartj\/eht248","article-title":"Mechanical circulatory support in cardiogenic shock","volume":"35","author":"Werdan","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1056\/NEJMoa1208410","article-title":"Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock","volume":"367","author":"Thiele","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/S0140-6736(13)61783-3","article-title":"Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): Final 12 month results of a randomised, open-label trial","volume":"382","author":"Thiele","year":"2013","journal-title":"Lancet"},{"key":"ref_30","first-page":"CD007398","article-title":"Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock","volume":"2015","author":"Unverzagt","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/S0735-1097(01)01553-4","article-title":"The current practice of intra-aortic balloon counterpulsation: Results from the Benchmark Registry","volume":"38","author":"Ferguson","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_33","first-page":"1","article-title":"The Current Use of Impella 2.5 in Acute Myocardial Infarction Complicated by Cardiogenic Shock: Results from the USpella Registry","volume":"27","author":"Schreiber","year":"2014","journal-title":"J. Interv. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1016\/j.jacc.2008.05.065","article-title":"A Randomized Clinical Trial to Evaluate the Safety and Efficacy of a Percutaneous Left Ventricular Assist Device Versus Intra-Aortic Balloon Pumping for Treatment of Cardiogenic Shock Caused by Myocardial Infarction","volume":"52","author":"Seyfarth","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jacc.2016.10.022","article-title":"Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction","volume":"69","author":"Ouweneel","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1161\/CIRCULATIONAHA.112.098194","article-title":"A Prospective, Randomized Clinical Trial of Hemodynamic Support with Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary Intervention: The PROTECT II Study","volume":"126","author":"Kleiman","year":"2012","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s40119-019-00152-8","article-title":"Complications of Temporary Percutaneous Mechanical Circulatory Support for Cardiogenic Shock: An Appraisal of Contemporary Literature","volume":"8","author":"Subramaniam","year":"2019","journal-title":"Cardiol. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1161\/CIRCULATIONAHA.120.048792","article-title":"Left Ventricular Unloading Is Associated with Lower Mortality in Patients with Cardiogenic Shock Treated with Venoarterial Extracorporeal Membrane Oxygenation: Results from an International, Multicenter Cohort Study","volume":"142","author":"Schrage","year":"2020","journal-title":"Circulation"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"469.e1","DOI":"10.1016\/j.ahj.2006.05.031","article-title":"A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock","volume":"152","author":"Burkhoff","year":"2006","journal-title":"Am. Heart J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/MAT.0000000000000195","article-title":"Hemodynamic Effects of Left Atrial or Left Ventricular Cannulation for Acute Circulatory Support in a Bovine Model of Left Heart Injury","volume":"61","author":"Kapur","year":"2015","journal-title":"ASAIO J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1093\/eurheartj\/ehi161","article-title":"Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock","volume":"26","author":"Thiele","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.jacc.2010.08.613","article-title":"The Percutaneous Ventricular Assist Device in Severe Refractory Cardiogenic Shock","volume":"57","author":"Kar","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_43","first-page":"E166","article-title":"Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology","volume":"7","author":"Makdisi","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/j.jacc.2014.03.046","article-title":"Extracorporeal Membrane Oxygenation in Cardiopulmonary Disease in Adults","volume":"63","author":"Abrams","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1177\/0267659118794112","article-title":"Left ventricular unloading during veno-arterial ECMO: A review of percutaneous and surgical unloading interventions","volume":"34","author":"Donker","year":"2019","journal-title":"Perfusion"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.athoracsur.2013.09.008","article-title":"Complications of Extracorporeal Membrane Oxygenation for Treatment of Cardiogenic Shock and Cardiac Arrest: A Meta-Analysis of 1866 Adult Patients","volume":"97","author":"Cheng","year":"2014","journal-title":"Ann. Thorac. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e004905","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905","article-title":"Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest: Cardinal Considerations for Initiation and Management","volume":"11","author":"Rao","year":"2018","journal-title":"Circ. Heart Fail."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MAT.0000000000001344","article-title":"Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement from the Extracorporeal Life Support Organization","volume":"67","author":"Richardson","year":"2021","journal-title":"ASAIO J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1093\/eurheartj\/ehz753","article-title":"Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study","volume":"41","author":"Bougouin","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1056\/NEJMoa2307227","article-title":"Extracorporeal Life Support in Infarct-Related Cardiogenic Shock","volume":"389","author":"Thiele","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s10047-020-01236-2","article-title":"Temporary surgical ventricular assist device for treatment of acute myocardial infarction and refractory cardiogenic shock in the percutaneous device era","volume":"24","author":"Singh","year":"2021","journal-title":"J. Artif. Organs"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1161\/CIRCULATIONAHA.122.062949","article-title":"Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial","volume":"147","author":"Ostadal","year":"2023","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Botti, G., Gramegna, M., Burzotta, F., Masiero, G., Briguori, C., Trani, C., Napodano, M., Scandroglio, A.M., Montorfano, M., and Tarantini, G. (2022). Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry. J. Pers. Med., 12.","DOI":"10.3390\/jpm12091481"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1016\/j.healun.2015.08.018","article-title":"Benefits of a novel percutaneous ventricular assist device for right heart failure: The prospective RECOVER RIGHT study of the Impella RP device","volume":"34","author":"Anderson","year":"2015","journal-title":"J. Heart Lung Transplant."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"53","DOI":"10.12659\/MSMBR.898897","article-title":"Concurrent Left Ventricular Assist Device (LVAD) Implantation and Percutaneous Temporary RVAD Support via CardiacAssist Protek-Duo TandemHeart to Preempt Right Heart Failure","volume":"22","author":"Schmack","year":"2016","journal-title":"Med. Sci. Monit. Basic Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jchf.2013.01.007","article-title":"Mechanical Circulatory Support for Right Ventricular Failure","volume":"1","author":"Kapur","year":"2013","journal-title":"JACC Heart Fail."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.healun.2017.07.005","article-title":"Eighth annual INTERMACS report: Special focus on framing the impact of adverse events","volume":"36","author":"Kirklin","year":"2017","journal-title":"J. Heart Lung Transplant."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.athoracsur.2019.12.005","article-title":"The Society of Thoracic Surgeons Intermacs 2019 Annual Report: The Changing Landscape of Devices and Indications","volume":"109","author":"Teuteberg","year":"2020","journal-title":"Ann. Thorac. Surg."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1093\/eurheartj\/ehad658","article-title":"Fully magnetically centrifugal left ventricular assist device and long-term outcomes: The ELEVATE registry","volume":"45","author":"Schmitto","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"584\u2013603; discussion 597\u2013598","DOI":"10.1016\/j.jtcvs.2012.05.044","article-title":"Long-term mechanical circulatory support (destination therapy): On track to compete with heart transplantation?","volume":"144","author":"Kirklin","year":"2012","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kuroda, T., Miyagi, C., Fukamachi, K., and Karimov, J.H. (2022). Biventricular assist devices and total artificial heart: Strategies and outcomes. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.951234"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.healun.2009.02.015","article-title":"INTERMACS Profiles of Advanced Heart Failure: The Current Picture","volume":"28","author":"Stevenson","year":"2009","journal-title":"J. Heart Lung Transplant."},{"key":"ref_63","unstructured":"(2025, December 27). NCA\u2014Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy (CAG-00432R)\u2014Decision Memo, Available online: https:\/\/www.cms.gov\/medicare-coverage-database\/view\/ncacal-decision-memo.aspx?proposed=N&NCAId=268."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.healun.2012.09.013","article-title":"The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: Executive summary","volume":"32","author":"Feldman","year":"2013","journal-title":"J. Heart Lung Transplant."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1056\/NEJMoa012175","article-title":"Long-Term Use of a Left Ventricular Assist Device for End-Stage Heart Failure","volume":"345","author":"Rose","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.healun.2010.01.011","article-title":"Clinical management of continuous-flow left ventricular assist devices in advanced heart failure","volume":"29","author":"Slaughter","year":"2010","journal-title":"J. Heart Lung Transplant."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1056\/NEJMoa0909938","article-title":"Advanced Heart Failure Treated with Continuous-Flow Left Ventricular Assist Device","volume":"361","author":"Slaughter","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1313385","article-title":"Unexpected Abrupt Increase in Left Ventricular Assist Device Thrombosis","volume":"370","author":"Starling","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1056\/NEJMoa1610426","article-title":"A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure","volume":"376","author":"Mehra","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1016\/j.jacc.2015.09.083","article-title":"Fully Magnetically Levitated Left Ventricular Assist System for Treating Advanced HF","volume":"66","author":"Netuka","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jacc.2010.05.016","article-title":"Acquired von Willebrand Syndrome After Continuous-Flow Mechanical Device Support Contributes to a High Prevalence of Bleeding During Long-Term Support and at the Time of Transplantation","volume":"56","author":"Uriel","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.jacc.2015.07.075","article-title":"Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients","volume":"66","author":"Estep","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_73","unstructured":"(2025, December 27). Premarket Approval (PMA), Available online: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfpma\/pma.cfm?id=p160054s008."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1056\/NEJMoa1800866","article-title":"Two-Year Outcomes with a Magnetically Levitated Cardiac Pump in Heart Failure","volume":"378","author":"Mehra","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1056\/NEJMoa1900486","article-title":"A Fully Magnetically Levitated Left Ventricular Assist Device\u2014Final Report","volume":"380","author":"Mehra","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.healun.2018.03.002","article-title":"Evaluation of low-intensity anti-coagulation with a fully magnetically levitated centrifugal-flow circulatory pump\u2014The MAGENTUM 1 study","volume":"37","author":"Netuka","year":"2018","journal-title":"J. Heart Lung Transplant."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1093\/ejcts\/ezx010","article-title":"First series of left ventricular assist device exchanges to HeartMate 3","volume":"51","author":"Hanke","year":"2017","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.1161\/CIRCULATIONAHA.111.058412","article-title":"Use of an Intrapericardial, Continuous-Flow, Centrifugal Pump in Patients Awaiting Heart Transplantation","volume":"125","author":"Aaronson","year":"2012","journal-title":"Circulation"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1056\/NEJMoa1602954","article-title":"Intrapericardial Left Ventricular Assist Device for Advanced Heart Failure","volume":"376","author":"Rogers","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1056\/NEJMoa040186","article-title":"Cardiac Replacement with a Total Artificial Heart as a Bridge to Transplantation","volume":"351","author":"Copeland","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1097\/MAT.0000000000000132","article-title":"Results with Syncardia Total Artificial Heart Beyond 1 Year","volume":"60","author":"Torregrossa","year":"2014","journal-title":"ASAIO J."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1053\/j.jvca.2016.03.002","article-title":"Impact of Body Mass Index on Outcomes in Cardiac Surgery","volume":"30","author":"Gao","year":"2016","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.healun.2017.09.002","article-title":"A bioprosthetic total artificial heart for end-stage heart failure: Results from a pilot study","volume":"37","author":"Carpentier","year":"2018","journal-title":"J. Heart Lung Transplant."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.healun.2011.04.004","article-title":"Survival after biventricular assist device implantation: An analysis of the Interagency Registry for Mechanically Assisted Circulatory Support database","volume":"30","author":"Cleveland","year":"2011","journal-title":"J. Heart Lung Transplant."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/j.athoracsur.2011.01.027","article-title":"Is Bridge to Recovery More Likely with Pulsatile Left Ventricular Assist Devices Than with Nonpulsatile-Flow Systems?","volume":"91","author":"Krabatsch","year":"2011","journal-title":"Ann. Thorac. Surg."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.healun.2020.12.006","article-title":"The results of a single-center experience with HeartMate 3 in a biventricular configuration","volume":"40","author":"McGiffin","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.healun.2016.12.006","article-title":"Improved outcomes from extracorporeal membrane oxygenation versus ventricular assist device temporary support of primary graft dysfunction in heart transplant","volume":"36","author":"Takeda","year":"2017","journal-title":"J. Heart Lung Transplant."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jtcvs.2008.09.021","article-title":"Early planned institution of biventricular mechanical circulatory support results in improved outcomes compared with delayed conversion of a left ventricular assist device to a biventricular assist device","volume":"137","author":"Fitzpatrick","year":"2009","journal-title":"J. Thorac. Cardiovasc. Surg."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/2\/177\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:34:50Z","timestamp":1770114890000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/2\/177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":88,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["bioengineering13020177"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13020177","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]}}}