Ventricular assist devices as a 'bridge to recovery': where do we stand?
The use of ventricular assist devices as a 'bridge to recovery' has a lot to promise. However, we are at a stage where there are more questions than answers. It is still difficult to predict who will be the right candidate and who will have sustained recovery after explantation of the device. In addition, we do not have a universally accepted protocol to wean patients from assist devices. A case that was successfully bridged to recovery with a left ventricular assist device is presented, together with a discussion of the literature. The search for precise markers of recovery should continue and a multicentre prospective study to validate weaning protocols is needed. At present, one should consider all available markers and look at the full clinical picture before allocating a patient to a bridge to recovery destination.
Ibrahim
Moheb
M
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. moheb.ibrahim@sympatico.ca
Hendry
Paul
P
D000328:Adult; D002316:Cardiotonic Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D017147:Defibrillators, Implantable; D017548:Echocardiography, Transesophageal; D005080:Exercise Test; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000628:therapy; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000628:therapy; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000628:therapy
D002316:Cardiotonic Agents