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Related Experiment Videos

Structural and left ventricular histologic changes after implantable LVAD insertion

P M McCarthy1, S Nakatani, R Vargo

  • 1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195.

The Annals of Thoracic Surgery
|March 1, 1995
PubMed
Summary
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Implantable left ventricular assist devices (LVADs) cause immediate heart structure changes. While acute myocyte damage markers improve, fibrosis increases, indicating altered loading, not true heart recovery.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Long-term support with implantable left ventricular assist devices (LVADs) can alter recipient heart structure.
  • Assessing potential heart recovery after LVAD support is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate structural and histological changes in the left ventricle of patients supported by HeartMate LVADs.
  • To determine if LVAD support leads to functional recovery of the heart.

Main Methods:

  • Review of records from 19 HeartMate LVAD recipients.
  • Intraoperative transesophageal echocardiography before LVAD insertion, immediately after, and at explantation.
  • Histological examination of myocardial tissue.

Main Results:

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  • LVAD initiation caused an immediate decrease in left ventricular dimensions, which persisted until explantation.
  • Left ventricular fractional shortening showed no significant improvement during LVAD support.
  • Histology revealed reduced acute myocyte damage markers but increased myocardial fibrosis.

    • Conclusions:

    • Implantable LVAD support induces immediate ventricular structural changes.
    • Histological improvements in myocyte damage markers are offset by increased fibrosis.
    • Observed changes reflect altered loading conditions rather than true left ventricular recovery.