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Thank You Beth and I thank the organizers for inviting me to speak at the symposium and welcome to Mount Sinai the elephant classes device use has increased over the past ten years and if one wonders why that is its because of the excellent job done by my colleagues in the coronary 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 these are my disclosures and the way I have set up the next 20 minutes is to introduce you to left ventricular assist devices more importantly take this information along with the patient that we our family with and then look at what evidence is there for the use of LRAD and then to look at what patient population that we can implant these devices and Ill be making any difference in the patients life heres a patient that we are all familiar with this is a 54 ye
