HEART FAILURE IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY, particularly among patients with advanced disease and no access to cardiac transplantation. Owing to the constant shortage of donor hearts, the role of left ventricular assist device (LVAD) has been expanding in the management of these patients both as a bridge to transplantation and as a destination therapy (i.e., alternative to transp...

BACKGROUND Data for left ventricular assist devices (LVADs) in patients with noninotrope-dependent heart failure (HF) are limited. OBJECTIVES The goal of this study was to evaluate HeartMate II (HMII) LVAD support versus optimal medical management (OMM) in ambulatory New York Heart Association functional class IIIB/IV patients meeting indications for LVAD destination therapy but not dependent...

OBJECTIVES We sought to study exercise capacity at different points in time after left ventricular assist device (LVAD) implantation and subsequent heart transplantation (HTx). BACKGROUND The lack of donor organs warrants alternatives for transplantation. METHODS Repeat treadmill testing with respiratory gas analysis was performed in 15 men with a LVAD. Four groups of data are presented. In...

AIM To investigate the impact of timing of same-admission orthotopic heart transplant (OHT) after left ventricular assist device (LVAD) implantation on in-hospital mortality and post-transplant length of stay. METHODS Using data from the Nationwide Inpatient Sample from 1998 to 2011, we identified patients 18 years of age or older who underwent implantation of a LVAD and for whom the procedur...

BACKGROUND The objective of this study was to evaluate the outcome of left ventricular assist device (LVAD) implantation after initial extracorporeal life support (ECLS) in patients with cardiogenic shock and the incidence of post implantation right ventricular failure. METHODS & RESULTS All patients on ECLS therapy for cardiogenic shock prior to LVAD implantation (n = 15) between October 201...

Background- Mechanical unloading of the heart with a left ventricular assist device (LVAD) leads to favorable changes in the biology of the failing cardiac myocyte. To determine a potential mechanism for these improvements, we examined the regulation of mitogen-activated protein kinases (MAPKs) in the failing heart in the presence and absence of LVAD support. Methods and Results- We examined th...

Heart transplantation provides considerable survival benefits for patients with end-stage heart failure, but it is available for only a small fraction of such patients all over the world due to donor shortage. Therefore, many heart transplant candidates require long-term support by a left ventricular assist device (LVAD) while they await transplantation. However, the long-term LVAD support can ...

L eft ventricular assist device (LVAD) thrombosis is a life-threatening complication occurring in ≈6% of patients receiving a HeartMate II (HMII) LVAD (Thoratec Corp, Pleasanton, CA) within 24 months after implantation. 1 Prophylactic therapy with aspirin and warfarin to an international normalized ratio (INR) of 1.5 to 2.5 is recommended to prevent LVAD thrombosis in most HMII recipients. 2 Fo...

BACKGROUND Recognizing that mechanical circulatory support with a left ventricular assist device (LVAD) induces changes in myocardial structure and contractile function, we examined whether there are changes in ventricular conduction and/or repolarization among failing human hearts after LVAD implantation. METHODS AND RESULTS We examined 12-lead electrocardiograms before surgery, immediately ...

BACKGROUND Left ventricular assist devices (LVAD) reverse ventricular, myocardial, and systemic abnormalities characteristic of severe heart failure (reverse remodeling). The relative contributions of hemodynamic unloading and normalized biochemical milieu to reverse remodeling are unknown. METHODS AND RESULTS Structural and functional characteristics were measured from 53 hearts of patients ...