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thank you Beth um and I thank the organizers for inviting me to speak at this Symposium and welcome to Mount [Applause] Si the left vental asses device um use has increased over the past 10 years and if one wonders why that is its because of the excellent uh job done by my colleagues in the colonary intervention lab and the electrophysiology lab where the patients are now living longer and as a result continue to develop heart failure and end up having end stage heart disease where they require an intervention and with that background set up um these are my disclosures and the way I have set up the next 20 minutes is to introduce you to um left ventricular assist devices more importantly um take this information along with the patient that we are all familiar with and then look at what evidence is there for the use of elad and then to look at what patient population that we can implant these devices and are we making any difference in the patients life here is a patient that uh we ar
