Technological advances and clinical application of left ventricular assist devices in the treatment of advanced heart failure

Left ventricular assist devices (LVADs) have become an important treatment for advanced heart failure, especially given the shortage of heart transplant donors. This article systematically reviews the technological evolution, perioperative assessment, pathophysiological changes, gender differences, functional recovery, and complication management of LVADs, focusing on the CH-VAD, a fully magnetically levitated centrifugal pump independently developed in China. Results show that LVAD technology has evolved from pulsatile flow devices to the third-generation magnetically levitated centrifugal pump, significantly improving blood compatibility and treatment safety. CH-VAD has demonstrated good efficacy and safety in clinical applications, with a 6-month and 1-year survival rate of 91.6%, a low rate of drive-line infection (11.0%), and unique advantages in complex anatomical cases. LVADs can effectively improve patients’ cardiac function, quality of life, and exercise tolerance, promoting cardiac remodeling and skeletal muscle recovery, but hemodynamic regulation during exercise remains limited. The risk of complications (stroke, infection) remains higher in female patients than in male patients. The prediction and management of right heart failure remains a key challenge affecting prognosis. In the future, it is necessary to combine biomarker-guided patient screening, gender-specific risk management, and the technological iteration of domestically produced equipment to promote the individualization and precision of LVAD treatment.