**2. Advancing therapies**

Worldwide, there are an increasing number of end stage heart failure patients with LVADs which now exceeds 100,000 of which 18,539 are reported in the Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) [5, 12] and 16,286 reported in the global IMACS registry collecting data from the United States, Europe, Japan, and United Kingdom [13]. As the end-stage heart failure pandemic continues to grow and alter the lives of multiple patients, LVAD advancements provide a viable option for patients as either a bridge to heart transplant or as destination therapy for those who are not transplant candidates.

MOMENTUM 3 is a landmark multicenter trial demonstrating the strides in LVAD technologies and decreasing patient complication rates. The centrifugal-flow LVAD, HeartMate III, demonstrated superior performance to the axial-flow LVAD, HeartMate II. The HeartMate III reduces shear stress, reduces friction, and prevents thrombosis. The primary outcome of the MOMENTUM 3 trial showed that 74.7% of patients with a HeartMate III survived without disabling stroke or reoperation to replace or remove a malfunctioning device at 2 years versus 60.6% of patients with the HeartMate II. Secondary outcomes of the study revealed decreased pump thrombosis, stroke, and bleeding events in the HeartMate III compared to the HeartMate II. The 3 year survival rate when utilizing HeartMate III now rivals that of heart transplantation [14]. This allows LVADs to extend life-prolonging therapy to patients not eligible for heart transplant and give patients an option that they never had before. The prevalence of adHF and life prolonging impact of LVADs worldwide makes the further development of LVAD care networks a pivotal part of delivering adHF care and improving patient outcomes.
