How Do I Advise My Heart Failure Patient About Left Ventricular Assist Device Therapy?

The next patient you are seeing in the cardiology office is a 69-year-old male with long standing ischemic cardiomyopathy. He has New York Heart Association Class III-IV symptoms with a left ventricular ejection fraction <20%. Previously, he was on all four main categories of guideline directed medical therapy with initial response but has now developed worsening heart failure symptoms despite escalation of medical therapy. On your last visit, you referred him to the heart failure team for consideration of advanced therapies. Unfortunately, he was not a candidate for heart transplant due to elevated body mass index as well as poorly controlled diabetes mellitus. However, left ventricular assist device therapy (LVAD) was offered. He was provided educational material on the HeartMate3™ (HM3, Abbott, Abbott Park, IL) device. Today, the patient asks for your guidance on this therapy option.

You provide him the following counsel:

Show Answer