Current practice in patient selecting for long-term mechanical circulatory support.

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Mechanical circulatory support (MCS) has advanced significantly over the last decade.
• Patient selection criteria for left ventricular assist device (LVAD) implantation have consequently evolved.
• Optimizing patient selection is crucial for improving outcomes in advanced heart failure treatment.

Purpose of the Study:

• To review the current state of patient selection for long-term circulatory support devices.
• To describe the evaluation and optimization processes prior to LVAD implantation.
• To highlight the impact of device advancements on patient selection.

Main Methods:

• Literature review of recent studies and clinical guidelines on LVAD patient selection.
• Analysis of trends in patient demographics and clinical profiles undergoing LVAD implantation.
• Synthesis of current best practices in pre-implantation patient assessment.

Main Results:

• Patient selection criteria have broadened, including sicker patients and new indications.
• Multidisciplinary evaluation is essential for comprehensive risk assessment.
• Optimization strategies focus on medical, nutritional, and psychosocial factors.

Conclusions:

• Current patient selection for LVADs is dynamic, driven by technological progress.
• Thorough pre-implantation evaluation and optimization are key to successful LVAD therapy.
• Continued research is needed to refine selection criteria and further improve patient outcomes.