HFA Congress 2026 — Dr Nir Uriel (NewYork-Presbyterian, New York, US) discusses findings from a comparative analysis evaluating survival outcomes in middle-aged and older patients with advanced heart failure treated with left ventricular assist device (LVAD) therapy or heart transplantation. 

Drawing on two prospectively collected data sets: the Momentum 3 trial (HeartMate 3) and the UNOS transplant registry. This analysis examined outcomes in patients with ischaemic and non-ischaemic cardiomyopathy across two age groups (50–64 and 65 and older), comparing survival from both time of listing and time of treatment to provide a more complete picture of the clinical decision-making landscape. 

Findings showed that when measured from time of listing, LVAD therapy was statistically superior to heart transplantation in patients aged 50–64, and numerically superior - though not statistically significant - in those aged 65 and older. When analysis began from time of treatment, heart transplantation was superior across both age groups. On the safety side, transplant recipients had significantly higher rates of infection and rejection, while LVAD recipients aged 65 and older showed a higher incidence of stroke compared with transplant patients.

Interview Questions:

1. What was the reasoning behind this study?
2. What was the study design and patient population?
3. What were your key findings?
4. What are your take-home messages?
5. What are the most important unanswered questions in the management of older patients with advanced heart failure, and where should future research be directed?

Recorded on-site at Heart Failure Association Congress 2026, Barcelona.
Editors: Jordan Rance
Videographer: TBC
Support: This is an independent interview produced by Radcliffe Cardiology.