Age Over 70: Heart Transplant or Ventricular-Assist Device?
Dramatic advances in VAD design and patient management have made mechanical circulatory support an attractive therapeutic option for the growing pool of elderly heart failure patients. There are three major indications for the use of VADs: 1) as a bridge to transplantation; 2) as a lifelong support alternative for patients deemed ineligible for heart transplantation, or so-called destination therapy; and 3) as a bridge to myocardial recovery. One of the most controversial issues in the field of patient selection for advanced heart failure is age. Many health care professionals are reluctant to list “elderly” candidates for transplant though the cutoff age varies. In contrast, there is no absolute age cutoff for VADs, and older patients may have easier access to mechanical pumps than to donor organs. During this session, two experts will debate the point/counterpoint for VAD-versus-heart transplant for this patient population. The criteria for patient selection for transplant and VADs, long-term survival and quality of life will be compared.
At the end of this educational activity, participants should be able to
- Debate the pros and cons of heart transplant versus VAD for patients over 70 years of age
- Compare the indications for and differences in long-term survival and quality of life for elderly patients with heart transplant versus mechanical circulatory support
Joseph G. Rogers, MD
Professor of Medicine
Interim Chief, Division of Cardiology
Vice Chair for Clinical Practice, Department of Internal Medicine
Duke University School of Medicine
Duke University Medical Center
Jeffrey Teuteberg, MD
Medical Director, Heart Transplantation
Director, Advanced Heart Failure Program
University of Pittsburgh Medical Center
Disclosures of Relevant Financial Relationships
In accordance with the ACCME Standards for Commercial SupportSM, OptumHealth Education requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or their spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the activity content over which the individual has control.
OptumHealth Education ensures that the content is independent of commercial bias.
Dr Rogers has indicated that he has no relevant financial relationships.
Dr Teuteberg has disclosed the following: Abiomed, Acorda Therapeutics (Advisory Board); CareDx Inc., HeartWare(Advisory Board, Speakers’ Bureau); Thoratec (Other Financial or Material Support).
Michael Abecassis, MD, MBA
Sarah Chart, RN
Eden Prairie, MN
Rebecca Gleason, RN, CCM
Eden Prairie, MN
Dixon B. Kaufman, MD, PhD, FACS
University of Wisconsin School of Medicine and Public Health
C. Fred LeMaistre, MD
Tina Rydland, PharmD
Crystal Clear Rx
V. Silverstein, MD
Eagle Creek Medical Communications
Activity Planner Disclosures
Drs Abecassis, Kaufman, LeMaistre, Rydland and Silverstein have indicated that they have no relevant financial relationships.
Ms Chart and Ms Gleason have indicated that they are employees of and own stock in UnitedHealth Group.
To ensure fair balance and avoid bias, the content for this activity has been reviewed by an independent medical expert with no relevant financial relationships.
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- Completing the entire activity
- Completing the Pre- and Post-Activity Assessments, Activity Evaluation, and Application for Certificate of Credit forms
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Method for Calculating CE Credit
CE credit was calculated by the complexity of content.
In support of improving patient care, OptumHealth Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the health care team.
Credit Designation Statements
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
The Commission for Case Manager Certification has approved this program for a maximum of 1.00 clock hour(s) for Certified Case Managers (CCM). (Please reference the 25th Annual National Conference when contacting CCMC to claim credit for this activity.)
This activity is approved for 1.00 contact hour(s) ([0.1] CEU) in states that recognize ACPE.
Attending the full program will earn 1.00 contact hour(s).
Unique Activity Number(s): 0860-0000-16-021-H01P/0860-0000-16-021-H01T
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This activity is designed to meet the educational needs of case managers, nurses, pharmacists, pharmacy technicians, physicians and other health care professionals who are interested in heart transplantation and ventricular-assist device (VAD).
This activity consists of recorded presentations from the "25th Annual National Conference" held in Minneapolis, MN on October 5–7, 2016.
- 1.00 ACPE - Pharmacist
- 1.00 ACPE - Pharmacy Technician
- 1.00 AMA
- 1.00 ANCC
- 1.00 Attendance
- 1.00 CCMC - General