A patient with advanced Chagas cardiomyopathy may be a candidate for heart transplant if indications are present.
Patient selection: Chagas cardiomyopathy
Recommendation I (conclusive evidence or general consensus)
(1) refractory heart failure (dependent on inotropic drugs, circulatory support and/or mechanical ventilation)
(2) VO2 peak <= 10 mL per kg per min
(3) ventricular fibrillation or refractory sustained ventricular tachycardia
(4) persistent heart failure NYHA III or IV with optimal therapy
Recommendation IIa (favored by evidence and approved by most professionals):
(1) VO2 peak <= 14 mL per kg per min without beta blockers or <= 12 with beta blockers
(2) cardiopulmonary test with LV to VCO2 ratio > 35 and VO2 peak <= 14 mL per kg per min
Recommendation IIB (less well established):
(1) NYHA class IV heart failure without optimal therapy
Recommendation III (no evidence of consensus and may be detrimental):
(1) NYHA class III heart failure without optimal therapy
