Limited experience around VAD deactivation
Those VADs that serve only as a bridge to transplant are
removed prior to transplantation and then become irrelevant.
However, VADs are increasingly being used for permanent
therapy either for destination by intent or for the patients in
whom the hope of transplantation will never be realized.
Indeed, only 42% of devices explicitly for bridging and 6%
of devices for “bridge to candidacy” were replaced by heart
transplants at the time of the last annual report of
INTERMACS.14 Thus the majority of VADs are for lifetime
support; although initially implanted for life prolongation,
they will eventually become end-of life VADs.