Advanced Heart Failure Patient Referral Information | Abbott
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Advanced Heart Failure Patient Referral

If your patient experiences any of the following, refer them to a heart failure specialist for evaluation for advanced heart failure therapies, including LVAD therapy.1

 

High-Risk Clinical Triggers

IV inotropes

I

NYHA IIIB/IV or persistently elevated natriuretic peptides

N

End-organ dysfunction (Cr > 1.8 mg/dL or BUN > 43 mg/dL)

E

EF ≤ 35%

E

Defibrillator shocks

D

Hospitalizations > 1 with heart failure

H

Edema (or elevated PA pressure) despite escalating diuretics

E

Low blood pressure, high heart rate

L

Prognostic medication — progressive intolerance or down-titration GDMT

P

Additional Considerations for Referral:¹

  • CRT non-responder
  • Physical activity limited or impaired QOL

HeartMate 3 LVAD Indication

The HeartMate 3™ Left Ventricular Assist System is indicated for providing short- and long-term mechanical circulatory support (e.g., as bridge to transplant or myocardial recovery, or destination therapy) in adult and pediatric patients with advanced refractory left ventricular heart failure and with an appropriate body surface area. 

Patient Profile

  • NYHA Class IIIB or IV
  • Heart failure hospitalization(s)
  • Unresponsive to diruetics or neurohormonal agents

Additional Considerations

  • Ejection Fraction < 35%2
  • Persistently high PA pressures4
  • Elevated Pro-BNP or BNP2
  • 6-Minute Walking Distance (6MWD) < 300m3

Patient Workup

Evaluating a heart failure patient for advanced therapies requires the integration of clinical, imaging, hemodynamic, functional and biomarker data.

The following tests and patient information may be needed when referring a patient for advanced heart failure evaluation and LVAD therapy.²

  • Physical examination
  • Blood tests
  • Chest x-rays
  • Electrocardiogram (EKG or ECG)
  • Echocardiography (abbreviated as "echo")
  • Exercise stress test
  • Radionuclide ventriculography or multiple-gated acquisition scanning (abbreviated as MUGA)
  • Cardiac catheterization
  • Magnetic resonance imaging (MRI)
  • 6-Minute Walk Test³

Referring Advanced Heart Failure Patients for Evaluation

When you refer your advanced heart failure patients to a HeartMate LVAD implant center, you can reassure them that:

  • They will undergo a complete and thorough evaluation to determine if they are a candidate for advanced therapies, including LVAD therapy.
  • Both they and their caregivers will receive additional details of the surgery. They’ll also have the opportunity to ask questions about the procedure, recovery, and living with their HeartMate 3 LVAD.
  • They can connect with a HeartMate 3 LVAD Patient Ambassador. Ambassadors are HeartMate 3 recipients who can speak with your patients about their experiences with a HeartMate LVAD.

Get the I-NEED-HELP Aid for Identifying Clinical Risk Triggers

References

  1. Maddox TM, Januzzi JL Jr, Allen LA, et al. 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. February 16, 2021;77(6):772-810.
  2. American Heart Association. Common Tests for Heart Failure. https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure/common-tests-for-heart-failure. Accessed June 30, 2021.
  3. Giannitsi S, Bougiakli M, Bechlioulis A, et al. 6- minute walking test: a useful tool in the management of heart failure patients. Ther Adv Cardiovasc Dis. 2019;13:1-10.
  4. Kilic A, Katz JN, Joseph SM, et al. Changes in pulmonary artery pressure before and after left ventricular assist device implantation in patients utilizing remote haemodynamic monitoring. ESC Heart Failure. 2019;6:138-145.
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