title: Mechanical bridging to improvement in severe acute "nonischemic, nonmyocarditis" heart failure.
abstract: Improved myocardial function has been observed in patients with acute myocarditis who have had short-term support with a ventricular assist system. Additionally, a limited number of patients with nonischemic cardiomyopathy have undergone successful device explantation after their myocardial function improved during ventricular assist system support. The authors present their experience with four patients who had acute, severe heart failure without coronary artery disease or biopsy-proven myocarditis. After receiving prolonged ventricular assist system support, all four patients had significantly improved left ventricular function, returning to New York Heart Association functional class I without inotropic therapy. In each case, dobutamine stress echocardiography and invasive hemodynamic tests were performed to confirm improvement of cardiac function before device explantation was undertaken. In all four cases, device explantation was followed by early successful maintenance of left ventricular function. These cases reveal a unique clinical syndrome that may be successfully treated with early institution of ventricular assist system support followed by explantation after myocardial recovery.
authors.affiliation: Cardiopulmonary Transplant Service and Cardiovascular Research Laboratories, Texas Heart Institute, 6624 Fannin, Suite 2420, Houston, TX 77030, USA.
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
authors.forename: Reynolds M
authors.initials: RM
authors.lastname: Delgado
authors.forename: Nanci
authors.initials: N
authors.lastname: Scroggins
authors.forename: Peggy
authors.initials: P
authors.lastname: Odegaard
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
mesh_terms: D000208:Acute Disease; D000328:Adult; D025401:Echocardiography, Stress; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged