Left ventricular assist devices (LVADs) are used in advanced heart failure for which purpose?

• A. Bridge to transplant or destination therapy in advanced HF
• B. Primary therapy for all HF
• C. Replacing the need for transplant
• D. Only for acute HF

Answer: (C)

Left ventricular assist devices provide durable mechanical support to a failing left ventricle, boosting cardiac output in patients with advanced heart failure who are not adequately controlled by medical therapy. The main use is twofold: as a bridge to transplant, where the LVAD keeps the patient stable while awaiting a donor heart, and as destination therapy, offering long-term support for patients who are not candidates for transplantation. They are not a universal primary treatment for all heart failure, nor do they eliminate the need for transplant in every case. They are also applicable in chronic, not only acute, heart failure scenarios.