Which of the following is an indication for a ventricular assist device?

• A. End-stage CHF
• B. Stable angina
• C. Isolated left main stenosis
• D. Normal LV function

Answer: (A)

Ventricular assist devices are used when the heart can no longer generate enough output despite optimal medical therapy, providing mechanical support to improve systemic perfusion. They’re most appropriate for advanced heart failure (end-stage CHF), often as a bridge to transplant or as destination therapy for patients not eligible for transplant. In these patients, the failing ventricle cannot sustain adequate forward flow, so a VAD can restore circulation and stabilize symptoms.

Stable angina arises from myocardial ischemia and is managed with antianginal therapy or revascularization, not with mechanical support. Isolated left main stenosis is a critical coronary lesion treated with PCI or CABG to restore flow, not with a VAD. Normal LV function means the heart pumps well, so there’s no indication for a ventricular assist device.