Optimal Timing of Referral of Heart Failure Patients for Left Ventricular Assist Device Implantation

Heart failure continues to increase in incidence and prevalence. The lack of donor hearts relative to a growing number of potential transplant recipients as well as the population of heart failure patients for whom transplant is not an option has prompted increasing interest in the use of left ventricular assist devices (LVADs). While there is attention given in the literature specific to optimizing management of patients' co-morbidities, the appropriate selection of patients, and timing of LVAD implantation to achieve optimal clinical outcomes, there is a lack of attention directed toward timing of referral of patients to advanced heart failure centers for evaluation for potential LVAD implantation. The purpose of this project was to retrospectively examine some common diagnostic indicators obtained at the referral or initial encounter pre-operatively and evaluate relationships with post-implantation outcomes, to examine which of those may influence the optimal timing of such referrals.

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