Changing our Approach to Stage D Heart Failure Article

Full Text via DOI: 10.1016/j.pcad.2017.08.003 PMID: 28801124 Web of Science: 000413610600006

Cited authors

  • Becnel, Miriam F.; Ventura, Hector O.; Krim, Selim R.


  • Despite the tremendous progress made in the management of heart failure (HE), many patients reach advanced stages. This paper aims to present a practical approach to the stage D HF patient who is no longer responding to optimal medical therapy. We discuss all available therapies for this patient population. We also offer some important caveats with regard to identification, risk stratification, evaluation and treatment including early patient referral to a center with an advanced HF program. Given the changing landscape of heart transplantation and an impending change in the allocation system, we also intend to engage a discussion on the need fora paradigm shift towards left ventricular assist device therapy in this population. (C) 2017 Elsevier Inc. All rights reserved.

Publication date

  • 2017

Published in

International Standard Serial Number (ISSN)

  • 0033-0620

Start page

  • 205

End page

  • 214


  • 60


  • 2