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Prognostic scoring systems for patient evaluation before left ventricular assist device implantation.

eart failure (HF) is a growing global health problem, with an estimated 150,000 new patients with endstage HF in the United States annually. Heart transplantation (HTx) is the only curative therapy but limited to only approximately 2,200 candidates per year because of persistent donor shortages.1 Recently, long-term circulatory support with a left ventricular assist device (LVAD) has become an important therapeutic option for the expanding advanced HF population, both as a bridge-to-transplantation (BTT) and as destination therapy (DT).2,3 In Japan, long average waiting periods for donor hearts resulted in average bridging periods surpassing 800 days.4 Thus, patients who wait for a donor are in virtually the same situation as those receiving DT even if the initial purpose was BTT. As the clinical utilization of LVADs expands, technologies are developing and patient selection becomes ever more important for successful LVAD implantation and long-term outcome. Thus, LVAD risk assessment needs to be further developed in line with advances in LVAD technological and clinical developments.