LVAD is a bridge to recovery in a surprising number of HF patients

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Takeaway 

  • A significant portion of patients with advanced heart failure (HF) and left ventricular assist device (LVAD) history can reach cardiac and physical functioning within same range as healthy control patients.
  • These patients can actually have their LVADs removed.

Why this matters  

  • LVADs usually serve as a bridge to transplantation, but some patients have shown signs of recovery even with end-stage HF, suggesting a role for LVAD as a bridge to recovery, too.

Key results 

  • At baseline, healthy control patients had better functional measures.
  • 37.5% (n=6) and 62.5% (n=10) of explanted LVAD patients, respectively, had peak exercise cardiac power output and peak exercise O2 consumption within ranges of age- and sex-matched healthy control patients.
  • That said, LVAD implanted and explanted patients on average still had significantly different values from healthy control patients (P<.05). 
  • Recovered patients seemed to sustain recovery for several years after explantation.

Study design

  • 58 men (18 implanted LVAD; 16 explanted LVAD; 24 heart transplant candidates) and 97 healthy control patients were included.
  • Funding: Author funding from university institutions, St. Jude Thoratec, and HeartWare.

Limitations

  • Small patient groups (all men).