{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T13:01:24Z","timestamp":1763038884206,"version":"3.45.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Temporary mechanical circulatory support (tMCS) is a life-saving intervention in cardiogenic shock (CS), though not without risks. Increasing attention has been given to ventricular unloading and its role in myocardial recovery, particularly in reversible cardiomyopathies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 35-year-old man presenting with CS was initially treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella (ECPELLA). Due to complications, support was escalated to Levitronix biventricular assist device. After 5 months of support and optimized medical therapy, substantial myocardial recovery enabled weaning from MCS and successful hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>MCS provides critical time to investigate the underlying cause of CS and assess the potential for recovery. This case illustrates how MCS can be both life-saving and a platform for ventricular unloading and neurohormonal optimization. Although full recovery is rare in severe cases, such strategies may improve cardiac function and enable successful weaning from support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf536","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T11:45:18Z","timestamp":1760787918000},"source":"Crossref","is-referenced-by-count":0,"title":["Biventricular unloading and rhythm control leading to biventricular recovery: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4635-9225","authenticated-orcid":false,"given":"Mar\u00eda","family":"de Miguel-Alava","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital of Valladolid , Ram\u00f3n y Cajal 3, Valladolid 47003 ,","place":["Spain"]},{"name":"Institute of Heart Sciences (ICICOR), Ramon y Cajal 3, Valladolid 47003 ,","place":["Spain"]},{"name":"Health Research Institute of Valladolid (IBioVALL), Ramon y Cajal 3, Valladolid 47003 ,","place":["Spain"]},{"name":"CIBER CV. Health Institute Carlos III. Monforte de Lemos 3-5, 28029 Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-5226","authenticated-orcid":false,"given":"Corry","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Department of Heart Failure, Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-6400","authenticated-orcid":false,"given":"Christophe","family":"Vandenbriele","sequence":"additional","affiliation":[{"name":"Department of Cancer and Surgery, Imperial College , Exhibition Rd, South Kensington, London SW7 2AZ ,","place":["UK"]},{"name":"Heart Center Aalst , Moorselbaan 164, Aalst 9300 ,","place":["Belgium"]},{"name":"Department of Adult Intensive Care, Royal Brompton and Harefield NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-4951","authenticated-orcid":false,"given":"Mohamed","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Transplant Surgery, Royal Brompton and Harefield NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3094-0867","authenticated-orcid":false,"given":"Fernando","family":"Riesgo-Gil","sequence":"additional","affiliation":[{"name":"Clinical Lead for Cardiology Transplant Medicine, Department of Heart Failure, Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"2025111307563638000_ytaf536-B1","first-page":"e1","article-title":"2023 ESC guidelines for the management of cardiomyopathies","volume":"24","author":"Arbelo","year":"2023","journal-title":"Eur Heart J"},{"key":"2025111307563638000_ytaf536-B2","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.cardfail.2019.01.012","article-title":"HFSA\/SAEM\/ISHLT clinical expert consensus document on the emergency management of patients with ventricular assist devices","volume":"25","author":"Givertz","year":"2019","journal-title":"J Card Fail"},{"key":"2025111307563638000_ytaf536-B3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s11886-020-1260-3","article-title":"Second hits in dilated cardiomyopathy","volume":"22","author":"Marstrand","year":"2020","journal-title":"Curr Cardiol Rep"},{"key":"2025111307563638000_ytaf536-B4","first-page":"e45590","article-title":"Comprehensive unloading strategy for rapid heart recovery under support with Impella","volume":"15","author":"Yamamoto","year":"2023","journal-title":"Cureus"},{"key":"2025111307563638000_ytaf536-B5","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/02676591241268389","article-title":"Science of left ventricular unloading","volume":"40","author":"Meani","year":"2024","journal-title":"Perfusion"},{"key":"2025111307563638000_ytaf536-B6","doi-asserted-by":"crossref","first-page":"e263","DOI":"10.1016\/j.jacc.2021.12.012","article-title":"2022 AHA\/ACC\/HFSA guideline for the Management of Heart Failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025111307563638000_ytaf536-B7","doi-asserted-by":"crossref","first-page":"e005220","DOI":"10.1161\/CIRCHEARTFAILURE.118.005220","article-title":"Clinical phenotype and genotype associations with improvement in left ventricular function in dilated cardiomyopathy","volume":"11","author":"Verdonschot","year":"2018","journal-title":"Circ Heart Fail"}],"container-title":["European Heart Journal - 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