Frailty in advanced heart failure (HF) is a growing and prevalent comorbid condition, occurring in approximately 50% to 65% of advanced HF patients.1–3  Frailty predisposes individuals to nearly a 5-fold increased risk of postoperative complications when undergoing cardiac surgical treatment modalities such as implantation of a durable left ventricular assist device (dLVAD) for advanced HF.4  This increased risk includes longer lengths of stay and increased 30-day readmissions.5  Although there is inconsistency in the conceptual and operational definitions of frailty, the most widely used definition focuses on the concept of frailty as a clinical syndrome with at least 3 of 5 applicable phenotype domains present: weight loss, weakness, self-reported exhaustion, low physical activity, or slow walking speed.6–8  The most common conceptual definition describes an association between this clinical syndrome and decreased reserve, increased vulnerability, and eventually poorer outcomes.6,7  Although the...

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