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.

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.

A preview of the emerging health care companies profiled in the current issue of Start-Up. This month's profile group, The Asthma Challenge: Not Solved Yet, features profiles of airPharma, Aperon Biosystems, Inverseon and Topigen Pharmaceuticals. Plus these Start-Ups across Health Care: Ensemble Discovery, Miikana Therapeutics, MiTiHeart and Resonant Medical.

The first left ventricular assist device (LVAD) to receive FDA approval as a primary therapy (rather than as a bridge to heart transplantation) is an older generation device with limited durability. With its third generation LVAD, MiTiHeart hopes it has the proper combination of a simple, robust and manufacturable design, low power consumption, and low rates of hemolysis, to serve a large, unmet need in congestive heart failure patients needing a permanent implant.