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Evidence to Improve Care

Left Ventricular Assist Devices for Destination Therapy


Ontario Health Technology Advisory Committee Recommendations

  • Ontario Health Technology Advisory Committee recommends that continuous-flow left ventricular assist devices (LVAD) be publicly funded as permanent therapy (also known as destination therapy) in patients with end-stage heart failure who are ineligible for heart transplantation.

  • Ontario Health Technology Advisory Committee recommends that the Cardiac Care Network and Trillium Gift of Life Network provide guidance regarding which hospitals should offer this procedure and which patients should be eligible.

  • Ontario Health Technology Advisory Committee further recommends that the Cardiac Care Network and/or Trillium Gift of Life Network ensures data is collected on survival and quality of life for individuals receiving continuous flow LVAD as permanent therapy, and that this data be reviewed by Ontario Health Technology Advisory Committee in 2 years.

Read the full OHTAC Recommendation report



A left ventricular assist device (LVAD), is a medical device that can be used to replace the function of a failing heart. It provides support to the damaged left ventricle (one of the four chambers of the heart) and helps pump blood to the rest of the body.

An LVAD is implanted under a patient’s skin. A control unit and battery pack are worn outside the body and connect to the LVAD through a hole in the skin. In Ontario, LVADs are publicly funded for patients who are waiting to have a heart transplant, and are currently not publicly funded for patients who are ineligible for a heart transplant.


Health Quality Ontario Reviews LVADs for Destination Therapy

Health Quality Ontario analyzed the effectiveness of LVADs as a destination therapy (long-term, permanent therapy) for patients with end-stage heart failure who are ineligible for heart transplantation.


Left Ventricular Assist Devices for Destination Therapy: A Health Technology Assessment (PDF) 
February 2016


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: In 2017/18, the Ministry began providing funding to support Left Ventricular Assist Devices for Destination Therapy at four hospitals.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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