Destination therapy: patient selection and current outcomes.

Area of Science:

• Cardiology
• Medical Devices
• Heart Failure Management

Background:

• Advanced heart failure affects a growing patient population.
• Left-ventricular assist devices (LVADs) offer a potential long-term treatment.
• Destination therapy (DT) with LVADs is an emerging alternative.

Purpose of the Study:

• To summarize clinical trials supporting LVADs as destination therapy.
• To review US national policies for DT candidate selection and center accreditation.
• To examine current guidelines, risk assessment tools, and outcomes for DT.

Main Methods:

• Review of clinical trials leading to LVAD DT approval.
• Analysis of US national policies on candidate selection and center accreditation.
• Synthesis of current guidelines and risk assessment tools for DT.

Main Results:

• Clinical trials demonstrated the efficacy of LVADs for destination therapy.
• Established national policies regulate candidate selection and DT center accreditation.
• Current guidelines and risk tools aid in assessing operative risk for DT candidates.

Conclusions:

• LVADs as destination therapy are a viable option for advanced heart failure.
• Regulatory frameworks ensure appropriate candidate selection and center standards.
• Ongoing review of outcomes will further refine DT protocols.