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The feasibility of left ventricular mechanical support as a bridge to cardiac recovery
Author(s) -
Liden Hans,
Karason Kristjan,
Bergh ClaesHåkan,
Nilsson Folke,
Koul Bansi,
Wiklund Lars
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.12.003
Subject(s) - medicine , heart failure , ventricular assist device , ejection fraction , myocarditis , cardiology , dilated cardiomyopathy , heart transplantation , weaning , transplantation , hemodynamics , cardiac output , cardiomyopathy , surgery
Objective To study the achievability of device weaning in patients receiving left ventricular assist devices (LVADs) as a bridge to transplantation. Methods Eighteen consecutive patients receiving a LVAD between September 1997 and June 2002 were included in the study. During a four‐month follow‐up, patients were repeatedly evaluated with right heart catheterization and echocardiography and, if functional improvement was observed, studied with the device turned off. Cardiac recovery was defined as off‐pump LVEF≥40% together with a significant improvement in invasive haemodynamic measurements (CI≥2.5 and PCWP≤10–12 mm Hg). Patients fulfilling these criteria were considered for weaning. Results Three patients fulfilled the predefined criteria for cardiac recovery and were subjected to device explantation. In one patient, a young female with acute myocarditis, the following course was uneventful. In the second patient, a male with dilated cardiomyopathy, heart failure reoccurred only a few days later. The third patient had a relapse of giant cell myocarditis and was transplanted. One patient underwent transplantation before follow‐up evaluation could be performed. Conclusion In our experience, patients with severe advanced heart failure are unlikely to show significant cardiac recovery following treatment with LVAD, in contrast to previous suggestions.