An LVAD indication includes an ejection fraction below what threshold?

• A. 25%
• B. 40%
• C. 60%
• D. 15%

Answer: (A)

An LVAD is considered when the left ventricle is severely failing and medical therapy alone is unlikely to maintain adequate perfusion. Ejection fraction reflects how much of the blood in the left ventricle is pumped out with each beat; a normal EF is about 55–70%. When EF falls to 25% or less, systolic function is markedly impaired, and the heart struggles to meet the body's demands even with best medical therapy. In this situation, an LVAD can unload the ventricle, reduce filling pressures, and improve forward flow, making ≤25% a commonly cited threshold for LVAD indication. Values higher than that indicate less severe dysfunction, while an EF as low as 15% can occur but is not the standard cutoff used for this indication.