Continuous-Flow Left Ventricular Assist Device Explantation After More Than 5 Years of Circulatory Support and Ventricular Reconditioning
Open Access
- 10 June 2021
- journal article
- research article
- Published by Texas Heart Institute Journal in Texas Heart Institute Journal
- Vol. 48 (2)
- https://doi.org/10.14503/thij-20-7266
Abstract
Continuous-flow left ventricular assist devices have proved to be effective, durable, life-saving tools in patients with end-stage heart failure. However, because of the risks associated with mechanical circulatory support (including stroke, infection, gastrointestinal bleeding, and device malfunction), the optimal goal of device therapy is myocardial recovery and device removal. Ventricular reconditioning and pump explantation after continuous-flow support have been reported; however, little is known about variables that govern the pace and degree of myocardial response in patients who experience such recovery. We describe our long-term pump-weaning strategy for a 25-year-old man who had a continuous-flow device implanted and then needed more than 5 years of support from it before developing cardiac reserve sufficient to enable pump explantation. To our knowledge, this is the longest period of uninterrupted continuous-flow device support to end in successful pump deactivation and a return to medical therapy. This case highlights the importance of actively and persistently pursuing a device-weaning strategy in all patients who need left ventricular assist device therapy.Keywords
This publication has 4 references indexed in Scilit:
- Ventricular reconditioning and pump explantation in patients supported by continuous-flow left ventricular assist devicesThe Journal of Heart and Lung Transplantation, 2015
- Long-term outcomes of patients bridged to recovery versus patients bridged to transplantationThe Journal of Thoracic and Cardiovascular Surgery, 2012
- Reversal of Severe Heart Failure With a Continuous-Flow Left Ventricular Assist Device and Pharmacological TherapyCirculation, 2011
- Improved Left Ventricular Function After Chronic Left Ventricular UnloadingThe Annals of Thoracic Surgery, 1996