Patient Population and Selection Criteria for Mechanical Circulatory Support

Abstract

Previous data has shown that elective left ventricular assist device (LVAD) implantation in ambulatory advanced heart failure patients can improve event-free survival and quality of life. The patient selection criteria for mechanical circulatory support (MCS) are complex as it involves integrating data from INTERMACS profile, clinical variables, invasive hemodynamic assessment, and recent hospitalization history. Identifying patients before incipient end organ failure ensues is key to prevent irreversible damage prior to LVAD implantation. Specific red flags that should warrant referral for advanced therapies include repeat hospitalizations, medication intolerance, worsening exercise cardiopulmonary stress testing, worsening cardiac hemodynamics, or inotrope dependence.