Left ventricular assist device recovery: does duration of mechanical support matter?

Binh N Pham, Sandra V Chaparro

Journal: Heart failure reviews 2020;24(2):237-244

PMID: 30302658

Abstract

Heart failure is a widespread condition in the United States that is predicted to significantly increase in prevalence in the next decade. Many heart failure patients are given a left ventricular assist device (LVAD) while they wait for a heart transplant, while those that are not able to undergo a heart transplant may be given an LVAD permanently. However, past studies have observed a small subset of heart failure patients that recovered cardiac function of their native heart after being placed on an LVAD. As a result, some patients have been able to have their LVAD explanted and no longer needed a heart transplant. In this review, we analyzed the data of 15 studies that observed recovery of cardiac function in LVAD patients in order to investigate the effects that duration of LVAD support has on patient outcomes. From our review, we identified that there may be negative consequences of prolonged duration of mechanical support such as myocardial atrophy and abnormal calcium cycling as well as circumstances that may allow for a longer duration of LVAD support such as in patients using a continuous-flow LVAD, non-ischemic cardiomyopathy patients, and the specific pharmacological therapy.

Address: University of Miami, Miller School of Medicine, Miami, FL, USA.; University of Miami, Miller School of Medicine, Miami, FL, USA. [email protected].; Department of Medicine, Cardiovascular Division, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Room 1110, Miami, FL, 33136, USA. [email protected].

DOI: 10.1007/s10741-018-9744-6

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https://doi.org/10.1007/s10741-018-9744-6

MeSH Terms: Adult, Atrophy, Calcium, Cardiomyopathy, Dilated, Clenbuterol, Female, Heart, Heart Failure, Heart Transplantation, Heart-Assist Devices, Humans, Male, Middle Aged, Myocardium, Prevalence, Recovery of Function, Survival Rate, Sympathomimetics, Time Factors, United States, Ventricular Remodeling