Clinical situations demanding weaning from long-term ventricular assist devices

Long-term results in patients with idiopathic dilated cardiomyopathy after weaning from left ventricular assist devices.

BACKGROUND Since our first successful left ventricular assist device (LVAD) explantation in a patient with idiopathic dilated cardiomyopathy (IDCM) in 1995, an additional 31 IDCM patients have been weaned in our department. Echocardiographic evaluations during repeated "off-pump" trials were the cornerstone for weaning decisions. After 9 years of experience, we assessed the reliability of our w...

Long-term ventricular assist devices in current clinical practice.

Percutaneous ventricular assist devices: clinical evidence

Efficient therapy of cardiogenic shock and optimal protection in high-risk p ercutaneous coronary intervention are still orphaned to ideal management. Intra-aortic b alloon pump and the newer percutaneous ventricular assist devices, such as TandemHeart and Impella Recover LP 2.5, have diversified the therapeutic arsenal with which one can tackle these clinical dilemmas. This article describes t...

Implantation of Short-Term and Long-Term Right Ventricular Assist Devices

The last decade has seen considerable growth in the use of left ventricular assist devices (LVAD), in end-phase heart failure treatment. The indications, contraindications and implantation techniques are well-defined. However, information about mechanical support for right ventricular failure is lacking. The aim of this communication is to present alternative techniques for implantation of shor...

Pre-explant stability of unloading-promoted cardiac improvement predicts outcome after weaning from ventricular assist devices.

BACKGROUND Detection of cardiac recovery that allows long-term cardiac stability after ventricular assist device (VAD) explantation is a major goal. After normalization of ventricular diameters during unloading, the pre-explant left ventricular ejection fraction (LVEF) allows the detection of patients with the potential to remain stable after VAD explantation. However, some patients with LVEF >...