To Explant or Not to Explant: An Invasive and Noninvasive Monitoring Protocol to Determine the Need of Continued Ventricular Assist Device Support
Article first published online: 27 JAN 2009
© 2009 Wiley Periodicals, Inc.
Congestive Heart Failure
Volume 15, Issue 2, pages 58–62, March/April 2009
How to Cite
Osaki, S., Sweitzer, N. K., Rahko, P. S., Murray, M. A., Hoffmann, J. A., Johnson, M. R., Edwards, N. M. and Kohmoto, T. (2009), To Explant or Not to Explant: An Invasive and Noninvasive Monitoring Protocol to Determine the Need of Continued Ventricular Assist Device Support. Congestive Heart Failure, 15: 58–62. doi: 10.1111/j.1751-7133.2008.00028.x
- Issue published online: 15 APR 2009
- Article first published online: 27 JAN 2009
- Manuscript received March 25, 2008; revised August 14, 2008; accepted October 10, 2008
Predictors of myocardial recovery after ventricular assist device (VAD) implantation are not well defined. The authors report their current VAD weaning protocol. Between 2003 and 2006, 38 patients received VAD implants. The authors performed 5 tests in 4 patients in whom echocardiography findings suggested myocardial recovery after implant. The protocol consists of assessing symptoms, electrocardiographic findings, hemodynamics, and cardiac function at baseline and as VAD support is weaned. As a result, 3 patients passed the weaning protocol and were explanted. There has been no recurrence of heart failure 667, 752, and 1007 days after explant, respectively. One patient failed the protocol after 151 days of support because of low cardiac index during the protocol. This patient was transplanted. This current experience of VAD weaning protocol is a novel tool to identify candidates for successful VAD explantation.