A 20-year-old man with idiopathic dilated cardiomyopathy underwent placement of a HeartMate II (Thoratec Corporation, Pleasanton, Calif) axial-flow left ventricular assist device (LVAD) as a bridge to cardiac transplant. The immediate postoperative phase was without complications. The LVAD was initially set at 8500 rpm. Under echocardiography guidance, a ramp-up study was performed to optimize ...

BACKGROUND When using a pulsatile left ventricular assist device (LVAD), it is important to reduce the cardiac load variations of the native heart because severe cardiac load variations can induce ventricular arrhythmia. In this study, we investigated the effect of counter-pulsation control of the LVAD on the reduction of cardiac load variation. METHODS A ventricular electrocardiogram-based c...

BACKGROUND Left ventricular assist devices (LVADs) are currently being evaluated as permanent therapy for end-stage heart failure. Because life-threatening infections limit successful long-term device implantation, we investigated the relationship between quantitative T-cell defects in LVAD recipients and CD95-mediated T-cell apoptosis. METHODS AND RESULTS Immunological studies were performed...

I n 1966, following a 4-h surgery, Dr. DeBakey implanted a left ventricular assist device (LVAD) in a patient experiencing post-cardiotomy shock. The patient was kept alive for 10 days until her own heart healed. This case has been recognized as the first successful use of an LVAD and has inspired the dream thatmyocardial recovery can occur when a failing heart is rested during LVAD. Over time,...

BACKGROUND Although LVADs are confirmed to have strong effects on aortic hemodynamics, the precise mechanisms of the helical flow component of LVAD outflow are still unclear. MATERIAL AND METHODS To clarify these effects, 3 cases - normal case, flat flow case, and realistic flow case - were designed and studied by using the CFD approach. The normal case denoted the normal aorta without LVAD sup...

Sustained recovery of the failing left ventricle (LV) during pressure-volume unloading with an LV assist device (LVAD) is rare and may be related to incomplete recovery of sarcomeric contractility. In this study, the authors evaluated contractility and biochemistry at the most fundamental contractile level of the heart: the sarcomere. Force development in muscle is the result of actin and myosi...

BACKGROUND Although cardiopulmonary exercise (CPX) testing is an established tool for predicting survival in patients with heart failure (HF), its prognostic impact on explantation of left ventricular assist device (LVAD) was unknown. METHODS AND RESULTS: We enrolled 33 patients who had undergone implantation of extracorporeal pulsatile flow LVAD and symptom-limited CPX testing at 3 months afte...

OBJECTIVE Right ventricular (RV) failure during left ventricular assist device (LVAD) support can result in severe hemodynamic compromise with high mortality. This study investigated the acute effects of cavo-pulmonary anastomosis on LVAD performance and RV myocardial compromise in comparison with biventricular circulatory support, in a model of biventricular failure. METHODS LVAD support was...

Ca2+ influx through the L-type calcium channel (LTCC) induces Ca2+ release from the sarcoplasmic reticulum (SR) and maintains SR Ca2+ loading. Alterations in LTCC properties, their contribution to the blunted adrenergic responsiveness in failing hearts and their recovery after support with LV assist devices (LVAD) were studied. L-type Ca2+ current (I(Ca,L)) was measured under basal conditions a...

Pectus excavatum deformity often remains clinically asymptomatic even in cases of a severely diminished thoracic volume and frequently remains uncorrected. In the patient population that requires left ventricular assist device (LVAD) placement, a diminished thoracic volume can be problematic and lead to significant challenges in pump and outflow cannula positioning. Here we present a case of pe...