[Human heart recovery during weaning from a left ventricular assist system: time course and outcome prediction]

To investigate the time course of recovery of a failing heart using the left ventricular assist system (LVAS) and to predict the outcome of weaning from the LVAS, 14 patients with a failing heart were studied. Among them, 5 had recovered and survived for more than 2 weeks after weaning from the LVAS (recovered group), while 9 could not be weaned or died within 2 weeks after weaning (unrecovered group). All patients were gradually weaned from the LVAS with adequate support for systemic circulation for 3 days. In the recovered group, indices of systolic time intervals (STIs) showed improvement within a week. However, improvement of STIs was slow reaching a plateau around the 10th day in the unrecovered group. On weaning from the LVAS, aortic systolic pressure and ejection time were regulated by the patients' own hearts and were nearly the same between the 2 groups. However, left atrial pressure was significantly higher in the unrecovered group than in the recovered group. These hemodynamic features were first present on the 7th day. Therefore, hemodynamic data on the 7th assistant day can be a reliable factor in predicting the possibility of successful weaning from the LVAS and recovery in patients with a failing heart.