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Comment & Response
September 23, 2020

Redefining Left Ventricular Assist Device Indications and Strategies

Author Affiliations
  • 1Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Virginia Commonwealth University, Richmond
  • 2Department of Anesthesiology, Virginia Commonwealth University, Richmond
JAMA Cardiol. 2021;6(1):119. doi:10.1001/jamacardio.2020.4303

To the Editor We read the study by Goldstein et al1 with great interest. Based on secondary analysis of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM) 3 trial showing superior outcomes with HeartMate 3 pumps, the authors challenge the utility of more than 2-decades-old predefined indications for left ventricular assist device (LVAD) therapy, namely, bridge to transplant, bridge to candidacy, and destination therapy. They advocate for a single preimplant indication, namely, extend survival and quality of life in those with medically refractory heart failure. We are not completely convinced by this idea.

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