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>or=40% together with a significant improvement in invasive haemodynamic measurements (CI>or=2.5 and PCWP<or=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.
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>or=40% together with a significant improvement in invasive haemodynamic measurements (CI>or=2.5 and PCWP<or=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.
Authors: Konstantinos G Malliaras; John V Terrovitis; Stavros G Drakos; John N Nanas Journal: J Cardiovasc Transl Res Date: 2008-09-30 Impact factor: 4.132
Authors: Stavros G Drakos; Abdallah G Kfoury; Josef Stehlik; Craig H Selzman; Bruce B Reid; John V Terrovitis; John N Nanas; Dean Y Li Journal: Circulation Date: 2012-07-10 Impact factor: 29.690
Authors: O Wever-Pinzon; J Stehlik; A G Kfoury; J V Terrovitis; N A Diakos; C Charitos; D Y Li; S G Drakos Journal: Pharmacol Ther Date: 2012-01-16 Impact factor: 12.310
Authors: Diego A Lara; Aamir Jeewa; Barbara A Elias; Elizabeth O McCullum; Susan W Denfield; William J Dreyer; Iki Adachi Journal: Tex Heart Inst J Date: 2017-02-01
Authors: Stavros G Drakos; Abdallah G Kfoury; Craig H Selzman; Divya Ratan Verma; John N Nanas; Dean Y Li; Josef Stehlik Journal: Curr Opin Cardiol Date: 2011-05 Impact factor: 2.161
Authors: Maria Chiara Todaro; Bijoy K Khandheria; Timothy E Paterick; Matt M Umland; Vinay Thohan Journal: Curr Cardiol Rep Date: 2014-04 Impact factor: 2.931
Authors: Zaid I Almarzooq; Anubodh S Varshney; Muthiah Vaduganathan; Manan Pareek; Garrick C Stewart; Jerry D Estep; Mandeep R Mehra Journal: JACC Cardiovasc Imaging Date: 2019-09-18