Table 3.

Summary of LVAD indications and patient selection criteria.

Indication	Criteria	Source
Bridge to Transplant (BTT)	Recommended for those listed for heart transplantation who are expected to decline before availability. The patients are likely to survive with MCS.	AATS, ISHLT [9]
Bridge to Recovery (BTR)	Myocarditis, peripartum cardiomyopathy, or other conditions where myocardial recovery is anticipated.	AATS, ISHLT [9]
Destination Therapy (DT)	Recommended for patients ineligible for heart transplantation but expected to benefit from long-term MCS, with preserved quality of life and compliance with post-implant care.	AATS, ISHLT [9]
General Health Requirements	Patients must have adequate kidney and liver function, absence of severe infections, good overall health beyond HF, stable mental health, and good social support.	ACC/AHA [11], ESC [12]
Comorbidities Considerations	Manage renal and hepatic dysfunction, frailty, and prior cardiac conditions. Avoid reversible heart failure causes and contraindications.	AATS, ESC [12], EACTS [5], ACC/AHA [11]
Advanced Heart Failure	NYHA Class III-IV, refractory to guideline-directed medical therapy, EF < 25%, stage D HF, and recurrent hospitalizations.	ESC [12], ACC/AHA [11], AACTS/ISHLT [9]
Hemodynamic Assessment	Assessment of cardiac output, pulmonary artery pressure, and lack of contraindications.	ESC [12]
Risk Stratification	INTERMACS 2–4, inotrope dependence, progressive end-organ dysfunction, peak VO2 < 12mL/Kg/min, temporary MCS dependence, or complications from previous treatments.	ESC [12], EACTS [5]
Special Considerations	Elevated pulmonary vascular resistance, renal failure, recent cancer, obesity, drug or alcohol recovery, multiple HF hospitalizations, hypotension, and sustained ventricular arrythmias	EACTS [5], ACC/AHA [11], ESC [12]