title: Bridge to recovery and weaning protocols.
abstract: The discovery of substantial myocardial improvement following the mechanical unloading afforded by left ventricular assist device (LVAD) therapy challenged the dogma of heart failure being irreversible. Since then, a significant experience with the use of LVAD therapy as a bridge to recovery has accumulated. The discovery of substantial structural and functional changes (reverse remodeling) in the myocardium has resulted in an intensive effort to define the biologic determinants of the reversibility of these changes. Herein the scientific foundations, clinical practice, and future of the use of LVADs as a bridge to recovery are reviewed.
authors.affiliation: Department of Cardiothoracic Surgery, Heart Science Centre, Harefield Hospital, National Heart and Lung Institute, Hill End Road, London UB9 6JH, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Magdi H
authors.initials: MH
authors.lastname: Yacoub
mesh_terms: D006333:Heart Failure / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bridge to recovery; Heart failure; LVAD