eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2014
vol. 11
 
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abstract:

Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support

Jerzy Pacholewicz
,
Michał Zakliczyński
,
Violetta Kowalik
,
Paweł Nadziakiewicz
,
Oskar Kowalski
,
Zbigniew Kalarus
,
Marian Zembala

Kardiochirurgia i Torakochirurgia Polska 2014; 11 (2): 169-172
Online publish date: 2014/06/30
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Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (HeartWare®) and a pulsatile pump (POLVAD MEV®), which allow regeneration of the native heart. Patients were qualified as INTERMACS level 3-4 for elective implantation of an LVAD. Implantations were performed without complications. The postoperative course was uncomplicated. In the HeartWare patient the follow-up was complicated by episodes of epistaxis and recurrent GIB as well as driveline infection. The follow-up of the LVAD MEV patient was uneventful. Recurrent GIB forced us to withdraw aspirin and warfarin therapy and maintain only clopidogrel. In mid-February 2013 the patient was admitted due to dysfunction of the centrifugal pump with a continuous low-flow alarm and increase power consumption. Under close monitoring of the patient a decision was made to stop the pump immediately and evaluate cardiac function. The serial echocardiography studies showed significant improvement in LVEF up to 45% and no significant valvular pathology. In February 2013 LVAD explant was performed by left thoracotomy without complications. At six-month follow-up the patient was in a good clinical condition, in NYHA class I/II, and on pharmacological treatment.
keywords:

heart failure, mechanical circulatory support

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