An increasing number of patients with heart failure need advanced therapy. Heart transplantation remains the definitive long-term treatment, but its use is limited by the low number of donor hearts. This limitation has led to the development of mechanical circulatory support devices that assist cardiac function by direct blood pumping (e.g. ventricular assist devices) and counterpulsation (e.g. the intra-aortic balloon pump). Ventricular assist devices provide long-term treatment for heart failure but are associated with potentially severe complications, such as driveline infection, stroke, and gastrointestinal bleeding. Counterpulsation improves cardiac function by augmenting diastole and reducing afterload, which increases coronary perfusion and decreases cardiac workload. Since the concept was introduced in 1960s, several devices have been used in humans. The intra-aortic balloon pump, a counterpulsation device, is the most commonly used device for short-term support as a bridge to transplant or recovery. A minimally invasive counterpulsation device, such as an intravascular ventricular assist system that allows ambulation, could potentially offer versatile solutions for long-term heart failure therapy or as a bridge to transplant or to recovery. The intravascular ventricular assist system has fewer complications and avoids the need for sternotomy or thoracotomy.
Long-term treatment with neutral endopeptidase inhibitor improves cardiac function and reduces natriuretic peptides in rats with chronic heart failure
