Left ventricular device as destination therapy: are we there yet?
Bibliographic record
Abstract
PURPOSE OF REVIEW: Mechanical circulatory assistance is evolving from bridge-to-transplant to destination therapy for end-stage heart failure patients. Recent studies document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure trial, as well as the outcomes of second-generation left ventricular assist devices (LVADs). RECENT FINDINGS: Post-Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure destination therapy patients receiving first-generation pulsatile flow devices have benefited from some improvement in 2-year outcomes and some reduction in the incidence of adverse events including device failure and sepsis. Despite these improvements, survival at 2 years remains poor and adverse events continue to portend significant morbidity and mortality. Second-generation continuous axial flow devices have demonstrated superior device durability and reliability as well as significant reductions in the incidence of sepsis and device-related infections in bridge-to-transplant patients. SUMMARY: Second-generation axial flow devices have significantly improved the adverse-event profile of LVAD therapy and are anticipated to offer substantial device longevity. Destination therapy is clearly an option for some patients with end-stage heart failure. As devices and experience evolve, outcomes will improve, which begs the question of whether these devices will have a role in the treatment of patients not as ill as those in the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure trial.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".