Table 2. Definition of advanced heart failure according to the ESC guidelines (13).

No.	Definition
1	Severe and persistent symptoms of heart failure [NYHA class III (advanced) or IV]
2	Severe cardiac dysfunction defined by at least one of the following:
	Left ventricular ejection fraction <30%
	Isolated right ventricular failure (for example tetralogy of Fallot, ccTGA, Ebstein’s anomaly, d-TGA with palliation according to Senning or Mustard)
	Non-operable severe valvular defects
	Non-operable severe congenital abnormalities
	High or increasing BNP or NT-proBNP levels and severe diastolic dysfunction or structural abnormalities
3	Episodes of pulmonary or systemic congestion requiring high-dose i.v. diuretics or episodes of low output requiring inotropes or arrhythmias causing >1 unplanned visit or hospitalization in the last 12 months
4	Severe impairment of exercise capacity with inability to exercise or low 6-minute walking distance (<300 m) or pVO2 <12 mL/kg/min or <50% predicted value, due to cardiac disease.

For diagnosis, the following criteria must be presented despite optimal medical treatment. NYHA, New York Heart Association-Classification; ccTGA, congenitally corrected transposition of the great arteries; BNP, B-type natriuretic peptide; NT-proBNP, N terminal-proBNP.