ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Niloo M. Edwards
Mehmet C. Oz
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Helman, D. N.
Right arrow Articles by Oz, M. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Helman, D. N.
Right arrow Articles by Oz, M. C.

Ann Thorac Surg 2000;70:1255-1258
© 2000 The Society of Thoracic Surgeons

Original articles: cardiovascular

Recurrent remodeling after ventricular assistance: is long-term myocardial recovery attainable?

David N. Helman, MDa, Simon W. Maybaum, MDb, David L.S. Morales, MDa, Mathew R. Williams, MDa, Ainat Beniaminovitz, MDa, Niloo M. Edwards, MDa, Donna M. Mancini, MDb, Mehmet C. Oz, MDa

a Division of Cardiothoracic Surgery, Department of Surgery, New York Presbyterian Hospital–Columbia Campus, College of Physicians and Surgeons of Columbia University, New York, New York, USA
b Division of Cardiology, Department of Medicine, New York Presbyterian Hospital–Columbia Campus, College of Physicians and Surgeons of Columbia University, New York, New York, USA

Address reprint requests to Dr Oz, Division of Cardiothoracic Surgery, New York Presbyterian Hospital, MHB 7-435, 177 Fort Washington Ave, New York, NY 10032
e-mail: mco2{at}columbia.edu

Background. Long-term left ventricular assist devices (LVAD) have been used both as a bridge to heart transplantation and to recovery of native myocardial function. Despite much evidence for reversal of some of the structural and functional changes present in the failing heart during LVAD support, clinical evidence for sustained myocardial recovery is scant. We describe 2 patients in whom myocardial recovery during LVAD support led to device explanation only to have heart failure recur. This necessitated a second LVAD implantation, a process that we have termed recurrent remodeling.

Methods. The medical records of 2 patients with cardiomyopathy supported with HeartMate LVADs (Thermo Cardiosystems, Inc, Woburn, MA) were retrospectively reviewed.

Results. One patient was supported with an LVAD for 2 months, at which time the LVAD was explanted. Progressive deterioration of cardiac function followed, requiring a second LVAD 19 months after LVAD explanation. After 2 months of further LVAD support, a second episode of apparent myocardial recovery was observed during a period of device malfunction. The other patient was supported with an LVAD for 12 months, at which time the LVAD was explanted. The patient experienced progressive hemodynamic deterioration and required a second LVAD 6 months after LVAD explantation. Heart transplantations of both patients were successful.

Conclusions. Our understanding of myocardial recovery in the setting of hemodynamic unloading with LVAD support has not yet progressed to the point where we are able to accurately predict successful long-term LVAD explantation. The evolution of reliable predictors of sustainable myocardial recovery will help to avoid further cases of recurrent remodeling requiring repeat LVAD implantation.




This article has been cited by other articles:


Home page
 J Am Coll CardiolHome page
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation
J. Am. Coll. Cardiol., April 14, 2009; 53(15): e1 - e90.
[Full Text] [PDF]

Home page
 CirculationHome page
2005 WRITING COMMITTEE MEMBERS, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation
Circulation, April 14, 2009; 119(14): e391 - e479.
[Full Text] [PDF]

Home page
 Eur J Heart FailHome page
H. Liden, K. Karason, C.-H. Bergh, F. Nilsson, B. Koul, and L. Wiklund
The feasibility of left ventricular mechanical support as a bridge to cardiac recovery
Eur J Heart Fail, May 1, 2007; 9(5): 525 - 530.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. Klotz, A.H. J. Danser, R. F. Foronjy, M. C. Oz, J. Wang, D. Mancini, J. D'Armiento, and D. Burkhoff
The Impact of Angiotensin-Converting Enzyme Inhibitor Therapy on the Extracellular Collagen Matrix During Left Ventricular Assist Device Support in Patients With End-Stage Heart Failure
J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1166 - 1174.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. Klotz, R. F. Foronjy, M. L. Dickstein, A. Gu, I. M. Garrelds, A.H. Jan Danser, M. C. Oz, J. D'Armiento, and D. Burkhoff
Mechanical Unloading During Left Ventricular Assist Device Support Increases Left Ventricular Collagen Cross-Linking and Myocardial Stiffness
Circulation, July 19, 2005; 112(3): 364 - 374.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Mizuno, R. D. Weisel, and R.-K. Li
Reloading the heart: A new animal model of left ventricular assist device removal
J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 99 - 106.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
H. Schima, M. Vollkron, H. Boehm, W. Rothy, M. Haisjackl, G. Wieselthaler, and E. Wolner
Weaning of rotary blood pump recipients after myocardial recovery: A computer study of changes in cardiac energetics
J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1743 - 1750.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
N.E. Bowles
The molecular biology of dilated cardiomyopathy
Eur. Heart J. Suppl., December 1, 2002; 4(suppl_I): I2 - I7.
[Abstract] [PDF]

Home page
 Eur Heart J SupplHome page
M.C Deng, D.D Ascheim, N.M Edwards, and Y Naka
End-stage heart failure: which options?
Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D122 - D130.
[Abstract] [PDF]

Home page
 J Am Coll CardiolHome page
N. de Jonge, D. F. van Wichen, M. E. I. Schipper, J. R. Lahpor, F. H. J. Gmelig-Meyling, E. O. Robles de Medina, and R. A. de Weger
Left ventricular assist device in end-stage heart failure: persistence of structural myocyte damage after unloading: An immunohistochemical analysis of the contractile myofilaments
J. Am. Coll. Cardiol., March 20, 2002; 39(6): 963 - 969.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. N. Kavarana, M. S. Pessin-Minsley, J. Urtecho, K. A. Catanese, M. Flannery, M. C. Oz, and Y. Naka
Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem
Ann. Thorac. Surg., March 1, 2002; 73(3): 745 - 750.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The Society of Thoracic Surgeons.