The feasibility of left ventricular mechanical support as a bridge to cardiac recovery

Research output: Contribution to journalArticle

Abstract

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. (C) 2007 European Society of Cardiology. Published by Elsevier B.V All rights reserved.

Details

Authors
  • Hans Liden
  • Kristjan Karason
  • Claes-Hakan Bergh
  • Folke Nilsson
  • Bansi Koul
  • Lars Wiklund
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • left ventricular assist device, mechanical, heart transplantation, support, recovery
Original languageEnglish
Pages (from-to)525-530
JournalEuropean Journal of Heart Failure
Volume9
Issue number5
Publication statusPublished - 2007
Publication categoryResearch
Peer-reviewedYes