After struggling for years to gain momentum, the ventricular assist device market appears finally to be coming of age. Second-generation VAD designs are performing well and seem to have largely addressed the pump durability and safety issues of the past that stymied growth and prevented this market from reaching its full potential. In the process, these new pumps, and their third-generation counterparts now waiting in the wings, are revitalizing interest in VADs among both physicians and patients, and propelling this potential multibillion dollar market to the forefront once again.

Medical device investors who have avoided heart failure, because of the long and uncertain development course of ventricular assist devices, should take another look. The minimally invasive revolution in heart failure, to some extent a logical extension of interventional cardiology's migration into other areas of structural heart disease like heart valves and PFOs, is providing new device opportunities, which have the potential to get to market sooner and at the same address an even larger patient population than heart failure devices that came before.

With the aging of the population, heart failure has emerged as a key public health concern. Several device-based technologies are poised to positively impact both ends of the disease spectrum, enabling earlier diagnosis and treatment, and providing more treatment options for those in later stages of the disease.