{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T06:48:29Z","timestamp":1777272509861,"version":"3.51.4"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mechanical restoration devices such as the Myosplint\u00ae were developed in the early 2000s to reshape left ventricular geometry and delay disease progression in patients with dilated cardiomyopathy. Despite initial safety and feasibility, long-term clinical efficacy remained limited. Today, patients with prior Myosplint\u00ae implantation may still present with end-stage heart failure requiring long-term mechanical circulatory support. However, device removal during HeartMate 3\u2122 LVAD implantation may pose technical challenges due to altered myocardial anatomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of a 65-year-old male with combined dilated and ischaemic cardiomyopathy and severe mitral valve regurgitation who had received two Myosplint\u00ae devices and mitral valve annuloplasty in 2001. After progressive decline in cardiac function, HeartMate 3\u2122 LVAD implantation was indicated. During surgery, the Myosplint\u00ae tendons were clearly visible through the apical coring site and were transected close to their insertion points without complication. The epicardial buttons were left in situ. Mitral valve replacement was not performed, as significant reduction in regurgitation was expected through adequate LV unloading alone. Postoperative recovery was uneventful, and follow-up echocardiography confirmed only mild residual mitral insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our case highlights a safe and straightforward technique for Myosplint\u00ae tendon management during HeartMate 3\u2122 LVAD implantation. It also supports a conservative approach to mitral valve intervention in select cases, suggesting that adequate LV unloading alone may suffice to reduce regurgitation. This experience provides guidance for surgeons managing patients with prior mechanical restoration devices undergoing LVAD implantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag088","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T12:44:16Z","timestamp":1772023456000},"source":"Crossref","is-referenced-by-count":0,"title":["Case report: failed restoration of left ventricular function after myosplint\u00ae placement followed by successful HeartMate 3\u2122 LVAD implantation"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5721-1162","authenticated-orcid":false,"given":"Philipp","family":"Schnackenburg","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, LMU Hospital , Marchioninistrasse 15, Munich 81377 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Kamla","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU Hospital , Marchioninistrasse 15, Munich 81377 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd","family":"Juchem","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU Hospital , Marchioninistrasse 15, Munich 81377 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU Hospital , Marchioninistrasse 15, Munich 81377 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph S","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU Hospital , Marchioninistrasse 15, Munich 81377 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"2026042702015995800_ytag088-B1","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s12265-014-9552-x","article-title":"Left ventricular restoration devices","volume":"7","author":"Oliveira","year":"2014","journal-title":"J Cardiovasc Transl Res"},{"key":"2026042702015995800_ytag088-B2","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1111\/j.1540-8191.2005.00157.x","article-title":"Initial safety and feasibility clinical trial of the myosplint device","volume":"20","author":"Fukamachi","year":"2005","journal-title":"J Card Surg"},{"key":"2026042702015995800_ytag088-B3","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/S1053-2498(01)00773-2","article-title":"Myosplint implant and shape-change procedure: intra- and peri-operative safety and feasibility","volume":"21","author":"Schenk","year":"2002","journal-title":"J Heart Lung Transplant"},{"key":"2026042702015995800_ytag088-B4","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1016\/j.athoracsur.2019.06.088","article-title":"HeartMate 3 implantation in a myosplint device-supported left ventricle","volume":"109","author":"Elgharably","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2026042702015995800_ytag088-B5","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/aor.13705","article-title":"The influence of left ventricular assist device inflow cannula position on thrombosis risk","volume":"44","author":"Ghodrati","year":"2020","journal-title":"Artif Organs"},{"key":"2026042702015995800_ytag088-B6","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.healun.2020.03.003","article-title":"Impact of left ventricular assist device implantation on mitral regurgitation: an analysis from the MOMENTUM 3 trial","volume":"39","author":"Kanwar","year":"2020","journal-title":"J Heart Lung Transplant"}],"container-title":["European Heart Journal - 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