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Patient Selection for Destination LVAD Therapy: Predicting Success in the Short and Long Term

  • Updates in Advanced Heart Failure (E. Rame and M. St. John Sutton, Section Editors)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In this review, we discuss risk assessment of advanced heart failure (HF) patients as a referral guide for advanced HF therapies, including left ventricular assist device (LVAD) support and cardiac transplant.

Recent Findings

The frequency of LVAD implantation for the purpose of permanent “destination” therapy is growing and survival on LVAD support is now approximating 50% at 5 years. Ambulatory HF patients with HF functional limitations, end-organ dysfunction, inability to tolerate HF medications, frequent cardiac admissions, and ventricular dysrhythmias are at high risk for mortality with medical management alone. Simultaneously, LVAD survival is superior in patients implanted prior to the onset of cardiogenic shock and/or multisystem dysfunction.

Summary

Early referral (< 7% annual predicted mortality) of patients with systolic heart failure to an advanced heart failure specialist is critical for achieving long-term survival.

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Authors and Affiliations

  1. Henry Ford Hospitals, 2799 W. Grand Blvd, K 14, Detroit, MI, 48202, USA

    Alexander Michaels & Jennifer Cowger

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  1. Alexander Michaels
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  2. Jennifer Cowger
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Correspondence to Jennifer Cowger.

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Conflict of Interest

Dr. Michaels declares no conflict of interest. Dr. Cowger is a paid speaker and consultant for Abbott and Medtronic, manufacturers of the HeartMate and HVAD products, respectively. Henry Ford receives clinical trial research funding from Abbott and Medtronic.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Michaels, A., Cowger, J. Patient Selection for Destination LVAD Therapy: Predicting Success in the Short and Long Term. Curr Heart Fail Rep 16, 140–149 (2019). https://doi.org/10.1007/s11897-019-00434-1

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