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Ann Thorac Surg 2003;75:S36-S41
© 2003 The Society of Thoracic Surgeons

Supplement

Bridge to recovery with the use of left ventricular assist device and clenbuterol

Jimmy K. F. Hon, MRCSa, Magdi H. Yacoub, FRSa*

a Department of Cardiothoracic Surgery, National Heart and Lung Institute at Royal Brompton and Harefield Hospitals, London, United Kingdom

* Address reprint requests to Dr Yacoub, Department of Cardiothoracic Surgery, Royal Brompton Hospital, Sydney St, London SW3 6NP, United Kingdom
e-mail: j.hon{at}ic.ac.uk

Presented at the Heart Failure & Circulatory Support Summit, Cleveland, OH, Aug 22–25, 2002.

Abstract

Treatment of heart failure using a left ventricular assist device (LVAD) is emerging as one of the most rapidly expanding areas. These devices are now used to treat patients with terminal heart failure not only as a bridge to transplantation but also for a bridge to recovery in certain carefully selected patients. More recently we have developed a strategy of combining LVAD support with pharmacologic therapies to produce maximal reverse remodeling followed by the induction of physiologic cardiac hypertrophy using clenbuterol, a selective ß2-adrenergic receptor agonist (the Harefield protocol). The purpose of this communication is to provide a brief review of remodeling, reverse remodeling, and the rationale for the use of clenbuterol to enhance the efficacy of the LVAD.




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