Left ventricular assist devices exchange: why, when and how to do it—experience from experts

Left ventricular assist devices (LVAD) became a routine instrument in the treatment of severe heart failure with constantly increasing number of patients treated with LVAD (1). Continuous technical development and large empirical knowledge in this field has led to a very high reliability and excellent long-term results (MOMENTUM III). Recently published results for the first time reported even better 2-year survival in LVAD compared to heart transplantation (HTx) (2). However, there is an inevitable risk of device failure alongside which may result in the need for device exchange. Mainly three causes are associated with the need for exchange, specifically (in the order of frequency) (I) device thrombosis, (II) infection and (III) device malfunction.