To ventricular assist devices or not: When is implantation of a ventricular assist device appropriate in advanced ambulatory heart failure?

Figure 1 Factors determining timing of left ventricular assist devices implantation. Factors for earlier implantation of left ventricular assist devices are increased survival and quality of life, avoidance of multi-organ deterioration and chronic low cardiac output while factors against earlier implantation are device-related events, surgical risks, and rehabilitation from surgery.