Author + information
- Received April 6, 2012
- Revision received August 29, 2012
- Accepted August 30, 2012
- Published online March 26, 2013.
- Leslie W. Miller, MD⁎ ( and )
- Maya Guglin, MD, PhD
- ↵⁎Reprint requests and correspondence:
Dr. Leslie Miller, Department of Cardiovascular Sciences, University of South Florida, 2 Tampa General Circle, 5075, Tampa, Florida 33606
The number of patients with advanced heart failure that has become unresponsive to conventional medical therapy is increasing rapidly. One of the most promising new alternatives to heart transplantation is use of ventricular assist devices (VADs). To date, there are no guidelines for appropriate selection for use of these devices that are approved by national societies in the field. This review addresses all of the general criteria for clinicians to keep in mind regarding when to refer a patient for evaluation and the specific issues addressed in patient selection. The field of mechanical circulatory support has advanced significantly over the past 10 years, resulting in rapid expansion of patients with advanced heart failure who can benefit from implantable devices. With progress of technology, limitations associated with age, body size, and comorbidities gradually become less prohibitive. The continuing simplification of design along with continued reduction in size of the devices, plus eventual elimination of the external drive line will make the use of VADs a superior option to heart transplant and even to medical management in many patients. We anticipate that the patient selection process outlined in the present review will continue to shift toward less advanced cases of heart failure.
Both authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 6, 2012.
- Revision received August 29, 2012.
- Accepted August 30, 2012.
- American College of Cardiology Foundation
- Indications for Mechanical Circulatory Support
- General Criteria for Patient Selection for Mechanical Circulatory Support
- Risk Scores
- Pulmonary Hypertension
- Right Ventricular Failure
- Renal and Hepatic Dysfunction
- Patient Size Considerations
- Structural Cardiac Diseases
- Moving to Patients With Less Severe Heart Failure
- Impact of New Devices