Pre-implant Patient Assessment and Optimization

Identification of suitable candidates for durable mechanical circulatory support (MCS), it is crucial to conduct a comprehensive and systematic evaluation of potential medical comorbidities. This assessment should follow a methodical head-to-toe approach. Organ systems to assess include neurological, cardiovascular, pulmonary, liver and gastrointestinal tract, renal, and hematology. Other critical assessments include obesity, age and frailty, malignancy and psychosocial considerations. Chemical dependency including tobacco and alcohol affects patients’ self-care ability and implantation in such candidates is considered a relative contraindication.