title: Patient selection for left ventricular assist devices.
abstract: Heart transplantation (HTx) improves symptoms and prolongs life in advanced heart failure (HF), but organ supply is limited. In recent years, mechanical circulatory support and specifically implantable left ventricular assist devices (LVADs) have undergone technical improvements, and outcomes have improved dramatically. Left ventricular assist devices are now viable options for patients with severe HF as bridge to transplantation, destination therapy, or as bridge to recovery. Many believe that LVADs may soon provide outcomes similar to, or better than, HTx, launching a new era of end-stage HF management. The key to improving outcomes is patient selection, but the field is changing rapidly and guidelines and consensus are limited. This review summarizes recent reports of predictors of poor outcomes and provides an overview of selection for LVAD therapy.
authors.affiliation: Department of Cardiology, Section for Heart Failure, Karolinska University Hospital, N305 171 76 Stockholm, Sweden. lars.lund@alumni.duke.edu
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lund
authors.forename: Jennifer
authors.initials: J
authors.lastname: Matthews
authors.forename: Keith
authors.initials: K
authors.lastname: Aaronson
mesh_terms: D017147:Defibrillators, Implantable; D006305:Health Status Indicators; D006333:Heart Failure / Q000628:therapy*; D006352:Heart Ventricles / Q000294:innervation*; D006353:Heart-Assist Devices; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D013997:Time Factors