What device is commonly used as a bridge to heart transplantation in patients with advanced heart failure?

• A. Left ventricular assist device
• B. Pacemaker
• C. Implantable cardioverter-defibrillator
• D. Intra-aortic balloon pump

Answer: (A)

When advancing heart failure patients are waiting for a donor heart, a device that provides sustained circulatory support is used to keep them stable and preserve organ function. A left ventricular assist device unloads the failing left ventricle and pumps blood into the aorta, improving systemic perfusion and allowing a patient to survive the transplant wait. Modern LVADs offer durable, long-term support and are specifically used as a bridge to transplantation (and can be used as destination therapy if transplantation isn’t possible).

Other devices serve different purposes. A pacemaker fixes rhythm problems but does not provide the level of cardiac output needed for an extended wait for a transplant. An implantable cardioverter-defibrillator reduces sudden death risk from arrhythmias but also does not provide continuous circulatory support. An intra-aortic balloon pump offers short-term, temporary hemodynamic support and is not suitable for long-term bridging to transplant.