Corheart 6 LVAS Study

Prior treatment

• 1\. Heart failure who can be treated with other therapy options (e.g. CRT, CRT-D, etc.)
• 2\. Intolerance to anticoagulant or antiplatelet therapies or any other peri/post-operative therapy the investigator will require based upon the patients' health status.
• 6\. Technical obstacles which pose an inordinately high surgical risk, in the judgment of the investigator.
• d. History of stroke within 180 days prior to enrollment, or a history of cerebrovascular disease with symptomatic (\> 70%) carotid artery stenosis
• 13\. STEMI \<2 weeks before planned implantation.
• 15\. Planned Bi-VAD support prior to enrollment.
• 16\. Cardiac arrest with a history of resuscitation 1-month before inclusion, without full restoration of cognitive function.

Other illness

• 5\. Psychiatric disease/ disorder, irreversible cognitive dysfunction or psychosocial issues that are likely to impair compliance with the study protocol and ventricular assist system management.
• 7\. Presence of an active, uncontrolled infection.
• 8\. Presence of any one of the following risk factors for indications of severe end organ dysfunction or failure:
• b. History of severe chronic obstructive pulmonary disease (COPD) defined by FEV1/FVC \< 0.7, or FEV1 \< 50% predicted.
• c. Fixed pulmonary hypertension with a most recent PVR ≥ 8 Wood units that is unresponsive to pharmacologic intervention.
• f. Significant peripheral vascular disease (PVD) accompanied by rest pain or extremity ulceration.
• 9\. Etiology of heart failure (HF) due to or associated with uncorrected thyroid disease, obstructive/ restrictive cardiomyopathy, pericardial disease, amyloidosis or giant cell myocarditis.
• 10\. Uncorrected moderate to severe aortic insufficiency without plans for correction during pump implant.
• 11\. History of confirmed, untreated abdominal aortic aneurysm (AAA) or thoracic aortic aneurysm (TAA) \> 5 cm in diameter.
• 14\. Right ventricular failure as defined by one or more of the following:
• 17\. History of any organ transplant.
• 19\. Any condition other than HF that could limit survival to less than 24 months.

Lab values

• 4\. Platelet count \< 100,000 x 10\^3/L (\< 100,000/ml).
• a. Total bilirubin \> 51.3 μmol/L (3.0 mg/dl), ischemic hepatitis, or biopsy proven liver cirrhosis, or clinically Child-Pugh B and C score.
• e. Serum creatinine ≥ 265 μmol/L (3.0mg/dl) or requiring dialysis.
• 18\. Pre albumin \< 150 mg/L, or Albumin \< 30g/L (3 g/dL).

Other

• 3\. Patient has known hypo or hyper coagulable states such as disseminated intravascular coagulation and heparin induced thrombocytopenia type II.
• 12\. Uncontrollable ventricular tachyarrythmias/ ventricular fibrillation (VF).
• a. severe depressed RV function in echocardiography
• b. TAPSE \< 1.0 cm
• c. CVP/PCWP ratio \> 0.63
• 20\. Positive pregnancy test if of childbearing potential.
• 21\. Lactating mothers.
• 22\. Participation in any other clinical investigation that is likely to confound study results or affect the study.
• 23\. Patients who have been placed in an institution by court order or by order of the authorities.

• 1\. Age ≥ 18 years and ≤ 75 years
• 2\. The patient has signed an Informed Consent Form
• 3\. Body Surface Area (BSA) ≥ 1.2 m\^2
• 4\. New York Heart Association (NYHA) Class IV
• 5\. Left Ventricular Ejection Fraction (LVEF) ≤ 25%
• 6\. Despite the optimal medical management based on current guidelines, the patient must also meet one or more of the following:
• a. Unable to exercise for HF,
• or
• if able to perform cardiopulmonary testing, with peak VO2 \<12 mL/kg/min and/or \< 50% predicted value;
• b. Progressive end-organ dysfunction (worsening renal and/or hepatic function, type II pulmonary hypertension, cardiac cachexia) due to reduced perfusion and not to inadequately low ventricular filling pressure (PCWP \> 20 mmHg and SBP \< 90 mmHg or CI \< 2.0 L/min/m2).
• c. Impella or IABP assisted;
• d. Inotrope dependent/unable to wean from inotropes.