Elective bridging to recovery after repair: the surgical approach to ventricular reverse remodeling.

We described our "surgical approach to reverse ventricular remodeling" in advanced chronic heart failure, based on the unique idea that "downstaging" class IV heart failure by supporting patients with left ventricular assist devices (LVADs) allows treatments mainly indicated for class III patients. The types of surgeries include mitral valve repair, surgical ventricular remodeling, coronary artery bypass grafting, and cardiac resynchronization. This approach has been applied to two patients with class IV chronic heart failure due to idiopathic dilated cardiomyopathy who were supported with the magnetically levitated Levacor LVAD. These were the first in-human implantations of this device. Sustained short- to medium-term recovery has been achieved in both patients.