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

Liden, Hans; Karason, Kristjan; Bergh, Claes-Hakan; Nilsson, Folke; Koul, Bansi LU and Wiklund, Lars (2007) In European Journal of Heart Failure 9(5). p.525-530
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
left ventricular assist device, mechanical, heart transplantation, support, recovery
in
European Journal of Heart Failure
volume
9
issue
5
pages
525 - 530
publisher
Elsevier
external identifiers
  • wos:000246530500013
  • scopus:34147187789
ISSN
1879-0844
DOI
10.1016/j.ejheart.2006.12.003
language
English
LU publication?
yes
id
19924321-3d0e-4dd5-a2d4-2b1ea15ea5f2 (old id 663608)
date added to LUP
2007-12-14 14:40:10
date last changed
2017-07-23 03:55:56
@article{19924321-3d0e-4dd5-a2d4-2b1ea15ea5f2,
  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 &gt;= 40% together with a significant improvement in invasive haemodynamic measurements (CI &gt;= 2.5 and PCWP &lt;= 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.},
  author       = {Liden, Hans and Karason, Kristjan and Bergh, Claes-Hakan and Nilsson, Folke and Koul, Bansi and Wiklund, Lars},
  issn         = {1879-0844},
  keyword      = {left ventricular assist device,mechanical,heart transplantation,support,recovery},
  language     = {eng},
  number       = {5},
  pages        = {525--530},
  publisher    = {Elsevier},
  series       = {European Journal of Heart Failure},
  title        = {The feasibility of left ventricular mechanical support as a bridge to cardiac recovery},
  url          = {http://dx.doi.org/10.1016/j.ejheart.2006.12.003},
  volume       = {9},
  year         = {2007},
}