The 2023 ISHLT Guidelines for Mechanical Circulatory Support: A 10-Year Update

Published 25 May 2023

Diyar Saeed, MD, PhD; David Feldman, MD, PhD; Aly El Banayosy, MD; Emma Birks, MD; Elizabeth Blume, MD; Jennifer Cowger, MD, MS; Christopher Hayward, MD; Ulrich Jorde, MD; Jamila Kremer, MD; Guy MacGowan, MD; Simon Maltais, MD, PhD; Simon Maybaum, MD; Mandeep Mehra, MD; Keyur B. Shah, MD; Paul Mohacsi, MD; Martin Schweiger, MD; Sarah E. Schroeder, ACNP-BC, MSN, RN; Palak Shah, MD, MS; Marvin Slepian, MD; Laurens F. Tops, MD, PhD; Paulino Alvarez, MD; Francisco Arabia, MD; Saima Aslam, MD; Louis Benson-Louis IV, MD; Edo Birati, MD; Holger W. Buchholz, MD; Ari Cedars, MD; Dawn Christensen, RN; Agnieszka Ciarka, MD; Erin Coglianese, MD; Rebecca Cogswell, MD; Jennifer Cook, MD; Jack Copeland, MD; Jose Gonzalez Costello, MD; Stavros G Drakos, MD, PhD; Pirooz Eghtesady, MD, PhD; Tonya Elliot, RN, MSN; Jerry D. Estep, MD; Jaime-Juergen Eulert-Grehn, MD; De Rita Fabrizio, MD; Jens Garbade, MD, PhD; Jill Gelow, MD; Maya Guglin, MD; Jaime Hernandez-Montfort, MD; Doug Horstmanshof, MD; Ranjit John, MD; Manreet Kanwar, MD; Feras Khaliel, MD; Gene Kim, MD; Sachin Kumar, MD; Jacob Lavee, MD; Marzia Leache, MD; Pascal Leprince, MD; Sern Lim, MD; Antonio Loforte, MD; Jiri Maly, MD; Samer Najjar, MD; Ivan Netuka, MD; Salpy V. Pamboukian, MD; Snehal R Patel, MD; Sean Pinney, MD; Christina Vander Pluym, MD; Evgenij Potapov, MD; Desiree Robson, RN; Yogita Rochlani, MD; Stuart Russell, MD; Kristin Sandau, PhD, RN; Elena Sandoval, MD; Gabriel Sayer, MD; Sarah Schettle, PA; David Schibilsky, MD; Thomas Schlöglhofer, MSc; Jan Schmitto, MD, PhD; Aleem Siddique, MD; Scott Silvestry, MD; Mark S Slaughter, MD; Benjamin Sun, MD; Hiroo Takayama, MD; Ryan Tedford, MD; Jeffrey J. Teuteberg, MD; Van-Khue Ton, MD, PhD; Nir Uriel, MD; Juliane Vierecke, MD; Daniel Zimpfer, MD, PhD; David D'Alessandro, MD

J Heart Lung Transplantation July 2023;42(7):E1-222.

• Cardiology
• Mechanical Circulatory Support
• Professional Guideline
• Publications & Journals
• Standards & Guidelines

In 2013, ISHLT published the first official guidelines for implantable MCS. Ten years later, the 2023 ISHLT Guidelines for Mechanical Circulatory Support: A 10-Year Update are available.

In addition to augmenting the content from the 2013 Guideline on preoperative, intraoperative, and postoperative management of MCS patients with implantable LVADs, the 2023 Guidelines also cover the management of patients with all configurations of durable MCS devices, including single and biventricular support. The update also accounts for notable changes that have occurred in the intervening years, such as the introduction and approval of the HeartMate III and the decision by Medtronic to discontinue new implants of the HVAD.

The writers for the updated Guidelines represent an international and multidisciplinary community, reflecting the membership of ISHLT.

They were organized into nine different task forces:

• Selection of candidates for DMCS and risk management prior to implantation for fixed comorbidities.
• Patient optimization, consent, and appropriate timing for MCS: Modifiable risk management prior to implantation.
• Intraoperative and immediate post-operative m­­­anagement
• Inpatient management of patients with DMCS.
• Outpatient management of the mechanical circulatory support device recipient.
• VAD in adults with congenital heart disease.
• Evaluation for recovery.
• Biventricular assist devices and total artificial heart specifications.
• Center quality metrics, outcomes, volume and staffing.
  

The 2023 MCS Guidelines Update represents a tremendous amount of work done over several years during tumultuous and challenging times in the medical communities.

Read at JHLT