#ACCMedStudent, it's Day 2 of #ACC21! Benefits of virtual meeting⏪old sessions available onDemand.
Great @ACCinTouch session yesterday on Advanced Heart Failure Therapies, ending w/ debate on Transplant vs. LVAD! #ACCHFT
🧵on some take-home points from the 6 presentations
1/ Moving Beyond NYHA Class #ACC21
Vague w/ wide inter & intra observer variability
Utility breaks down in advanced HF
🌟Reclassifying advanced HF: INTERMACS Profiles (lower score = sicker) helps prognosis/triage
🔑Assign profile after identifying features of advanced HF
2/ Cardiac Transplantation #ACC21
♦️ Strategies to expand cardiac donor pool➡️ donation after circulatory death (DCD) - first performed in Duke Dec 2019
♦️ Advances in post-transplant care➡️prevention of cardiac allograft vasculopathy & molecular tools for rejection monitoring
3/ Long-term mechanical circulatory support #ACC21
LVAD issues: stroke, GI bleeding, RHF, drive-line infection
📢Future📢
FiVAD: wireless pump, less driveline infections
Carmat: pulsative biventricular flow
🤯w/ all the innovation
4/ Decision Making Tools #ACC21
Better decisions =⬆️patient engagement
DECIDE-LVAD trial: shared-decision making improved concordance b/w caregiver values & treatment choice
EPIC-HF trial: electronic patient activation tool before cardiology visit improved GDMT intensification
5/ Debate: treatment of end-stage HF in inotrope-dependent 30yo w/ familial cardiomyopathy #ACC21
Cardiac Transplantation🆚LVAD
🟢patient survival?
🟢hospital readmission?
🟢patient preference and quality of life?
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