Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5619580 | Progress in Cardiovascular Diseases | 2017 | 36 Pages |
Abstract
Despite the tremendous progress made in the management of heart failure (HF), many patients reach advanced stages. This paper aims to present a practical approach to the stage D HF patient who is no longer responding to optimal medical therapy. We discuss all available therapies for this patient population. We also offer some important caveats with regard to identification, risk stratification, evaluation and treatment including early patient referral to a center with an advanced HF program. Given the changing landscape of heart transplantation and an impending change in the allocation system, we also intend to engage a discussion on the need for a paradigm shift towards left ventricular assist device therapy in this population.
Keywords
HFSSTAHSHFMOMTINTERMACSBTTCPXIABPRERLVADACCNYHARHCECMOVO2LBMMCsAHAInteragency Registry for Mechanically Assisted Circulatory SupportAmerican Heart AssociationNew York Heart AssociationExtracorporeal membranous oxygenationUnited StatesCardiac outputCardiopulmonary exercise testingminute ventilationLean body massoptimal medical therapyleft ventricular assist deviceICDCarbon dioxideUnited Network of Organ SharingBlood pressureTotal artificial heartdestination therapyheart failureRespiratory exchange ratioMechanical circulatory supportbridge to transplantintra-aortic balloon pumpHeart transplantationRight heart catheterizationImplantable cardioverter-defibrillatorAmerican College of CardiologyCO2UNOS
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Authors
Miriam F. Becnel, Hector O. Ventura, Selim R. Krim,