Key result
A patient with dilated cardiomyopathy experienced heart failure remission and lived a normal life for over 13 years after LVAD explantation before requiring a second device.
Case Report (n=1)
No
Mechanical unloading with an LVAD can induce prolonged remission of heart failure (over 13 years) in select patients with dilated cardiomyopathy, though the underlying disease process may eventually necessitate repeat mechanical support.
Supports possibility of durable remission after LVAD explant in dilated cardiomyopathy; leaves open predictors of sustained recovery.
Mechanical cardiac unloading with use of a left ventricular assist device (LVAD) is associated with substantial improvements in left ventricular function and enables subsequent LVAD explantation in some patients. We describe the case of a 35-year-old man with dilated nonischemic cardiomyopathy who was supported with an LVAD for 9 months. After the device was removed, he led a normal life for 13 years and 4 months. However, at 49 years of age, he presented with new signs and symptoms of heart failure, necessitating implantation of a 2nd LVAD. Afterwards, he has remained asymptomatic. This case is unique in that the patient lived a normal life for longer than a decade before renewed left ventricular decompensation necessitated repeat LVAD therapy. Histologic examination revealed few changes between the first device's removal in 1999 and the 2nd device's implantation in 2012.
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Segura et al. (2014) conducted a case report in Advanced heart failure due to idiopathic dilated cardiomyopathy (n=1). Left Ventricular Assist Device (LVAD) was evaluated. A patient with dilated cardiomyopathy experienced heart failure remission and lived a normal life for over 13 years after LVAD explantation before requiring a second device.
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