4.3 Levels of the Interagency Registry for Mechanically Assisted Circulatory Support The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) and the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) stratify patients with advanced HF into 7 levels that are useful for guiding patient evaluation (Supplementary Material, Table S1) [10]. A majority of patients included in LT-MCS trials had INTERMACS levels 1–4. Outcomes with LT-MCS in INTERMACS level 1 are poorer than those in levels 2–3 and bridging with temporary MCS in the former is recommended [11, 12].