Mechanical Circulatory Support as Bridge to Candidacy

Implant of long-term mechanical circulatory support (MCS), ventricular assist device (VAD), or total artificial heart (TAH) in patients who are not yet on the heart transplant (HTX) waiting list, in whom actual or future eligibility for HTX has been neither ascertained nor excluded, is not uncommon in clinical practice. This strategy can be defined as “bridge to candidacy” (BTC); including in this group also are patients with the highest degree of uncertainty, in whom MCS strategy is sometimes classified as “bridge to decision.”