title: Heart failure in remission for more than 13 years after removal of a left ventricular assist device.
abstract: 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.
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Segura
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: Lamia
authors.initials: L
authors.lastname: Dris
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: Edward K
authors.initials: EK
authors.lastname: Massin
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Clubb
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: L Maximilian
authors.initials: LM
authors.lastname: Buja
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
authors.affiliation: Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Taegtmeyer
mesh_terms: D000328:Adult; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020878:Device Removal; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D020127:Recovery of Function; D012008:Recurrence; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Cardiomyopathy, dilated/physiopathology/therapy; device removal; heart failure/physiopathology/therapy; heart-assist devices; myocytes, cardiac/pathology; recovery of function/physiology; recurrence; time factors; treatment outcome; ventricular dysfunction, left/physiology; ventricular remodeling