2023 ISHLT MCS Guidelines Update Now Available

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In 2013, ISHLT published the first official guidelines for implantable MCS. Now, ten years later, the 2023 ISHLT Guidelines for Mechanical Circulatory Support: A 10-Year Update is available on JHLT.org! 

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 covers 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:

1.  Selection of candidates for DMCS and risk management prior to implantation for fixed comorbidities.
2.  Patient optimization, consent, and appropriate timing for MCS: Modifiable risk management prior to implantation.
3.  Intraoperative and immediate post-operative management
4.  Inpatient management of patients with DMCS.
5.  Outpatient management of the mechanical circulatory support device recipient.
6.  VAD in adults with congenital heart disease.
7.  Evaluation for recovery.
8.  Biventricular assist devices and total artificial heart specifications. 
9.  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.