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Related Experiment Videos

Bridging-to-recovery.

R Hetzer1, J H Müller, Y Weng

  • 1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum, Berlin, Germany. hetzer@dhzb.de

The Annals of Thoracic Surgery
|March 27, 2001
PubMed
Summary
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Selected patients with end-stage heart failure can be weaned from cardiac assist devices, potentially avoiding heart transplantation. However, predicting successful weaning remains challenging.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Patients with end-stage heart failure often receive cardiac assist devices (CADs) for improved cardiac function.
  • A subset of patients show significant cardiac recovery, allowing for device removal and avoidance of heart transplantation.
  • This study reports long-term outcomes for patients successfully weaned from CADs.

Purpose of the Study:

  • To evaluate the feasibility and long-term outcomes of weaning patients from left ventricular support systems.
  • To identify potential predictors of successful device explantation and cardiac recovery.
  • To compare outcomes between weaned patients and those who underwent transplantation.

Main Methods:

  • Retrospective analysis of 95 patients with nonischemic, idiopathic, dilated cardiomyopathy implanted with left ventricular support systems between 1994 and 2000.

Related Experiment Videos

  • Echocardiography was used to assess cardiac function, specifically left ventricular diameter in diastole (LVIDd) and left ventricular ejection fraction (LVEF).
  • Criteria for weaning included LVIDd < 60 mm and LVEF > 40% under device support, with further assessment during brief device deactivation.

    • Main Results:

    • Twenty-eight out of 95 patients (29.5%) met criteria for weaning.
    • Sixteen patients (17% of the cohort) were successfully weaned and maintained "normal" heart function with follow-up up to 5.5 years.
    • Significant differences were observed in duration of heart failure, pre-explantation LVIDd, and LVEF between weaned patients and those transplanted or deceased.

    Conclusions:

    • Weaning from cardiac assist devices is a feasible option for carefully selected patients, potentially saving donor hearts.
    • Successful weaning offers an alternative to cardiac transplantation.
    • Currently, no reliable pre-implantation parameters predict successful weaning or long-term outcomes.