Key result
Continuous flow left ventricular assist devices improve the prognosis of patients with stage D heart failure, with optimal indications being INTERMACS profiles 2 to 4.
Why the study?
When should left ventricular assist devices with continuous flow pumps be implanted in patients with stage D heart failure?
When should left ventricular assist devices with continuous flow pumps be implanted in patients with stage D heart failure?
Continuous flow left ventricular assist devices have improved prognosis in stage D heart failure, expanding the indications to less sick patients, particularly relevant following new device approvals in Japan.
May support LVAD use in INTERMACS 2-4 stage D HF; leaves open optimal thresholds pending prospective validation.
The new classification of heart failure in the American College of Cardiology/American Heart Association guidelines includes stage D, which is refractory severe heart failure that does not respond to medical or resynchronization therapy. Among the many treatment strategies for stage D heart failure, only heart transplantation and ventricular assist devices have been established as improving prognosis. With the evolution in the mechanics of ventricular assist devices in recent years, the postoperative prognosis has improved, and less sick patients can now be candidates for these devices. In Japan, 2 continuous flow devices have been approved since April 2011, and now is the best time to consider the indications for their use.
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Koichiro Kinugawa (2011) conducted a review in Stage D Heart Failure. Left Ventricular Assist Devices (LVADs) vs. Medical therapy was evaluated. Continuous flow left ventricular assist devices improve the prognosis of patients with stage D heart failure, with optimal indications being INTERMACS profiles 2 to 4.
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