SPECIAL COMMENTARIESSelection and management considerations to enhance outcomes in patients supported by left ventricular assist devicesLander, Matthewa; Bhardwaj, Anjub; Kanwar, Manreeta Author Information aCardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania bUniversity of Texas Health Science Center, Houston, Texas, USA Correspondence to Manreet Kanwar, 320 E North Avenue, 16th Floor ST, Pittsburgh, PA 15212, USA. Tel: +1 412 359 4760; e-mail: [email protected] Current Opinion in Cardiology: November 2022 - Volume 37 - Issue 6 - p 502-510 doi: 10.1097/HCO.0000000000000996 Buy Metrics Abstract Purpose of review Left ventricular assist devices (LVADs) are life-saving therapies for patients in end-stage heart failure (HF) with reduced ejection fraction regardless of candidacy for heart transplantation. Multiple clinical trials have demonstrated improved morbidity and mortality with LVADs when compared to medical therapy alone. However, the uptake of LVADs as a therapeutic option in a larger section of end-stage HF patients remains limited, partly due to associated adverse events and re-hospitalization. Recent Findings Accurate assessment and staging of HF patients is crucial to guide appropriate use of LVADs. Innovative methods to risk stratify patients and manage cardiac and noncardiac comorbidities can translate to improved outcomes in LVAD recipients. Inclusion of quality of life metrics and measurements of adverse events can better inform heart failure cardiologists to help identify ideal LVAD candidates. Addition of machine learning algorithms to this process may guide patient selection to improve outcomes. Summary Patient selection and assessment of reversible medical comorbidities are critical to the postoperative success of LVAD implantation. Identifying patients most likely to benefit and least likely to experience adverse events should be a priority. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.