{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:46:15Z","timestamp":1778219175630,"version":"3.51.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>To manage myocardial recovery in patients with the HeartWare left ventricular assist device (HVAD), we describe a minimally invasive approach (decommissioning) that involves disconnecting the driveline and occluding the outflow tract through a small left thoracotomy incision, leaving the device <jats:italic toggle=\"yes\">in situ<\/jats:italic>, in conjunction with optimal medical therapies and comprehensive assessment of left ventricular recovery. Nine patients (all male, 37\u2009\u00b1\u200912 years, all nonischemic dilated cardiomyopathy) had an HVAD implanted for 766\u2009\u00b1\u2009343 days. When left ventricular function improved to mild impairment by echocardiography, patients underwent assessment at reduced flow (2578\u2009\u00b1\u2009148 to 1822\u2009\u00b1\u200967\u2009rpm) with documentation of compensated right heart hemodynamics and ejection fraction 52\u2009\u00b1\u20098%. Eight of nine patients underwent decommissioning, and 1 patient had a hybrid procedure of percutaneous occlusion of outflow graft and surgical division of driveline. Two patients died postoperatively at 413 days (sepsis) and 810 days (heart failure). In conclusion, in selected patients with nonischemic dilated cardiomyopathy, a prolonged period of HVAD support in conjunction with heart failure medications can lead to recovery of left ventricular function. Surgical decommissioning is then an option to remove these patients from support. These patients are, however, not cured and remain at risk for future deterioration in ventricular function and infections.<\/jats:p>","DOI":"10.1097\/mat.0000000000000523","type":"journal-article","created":{"date-parts":[[2017,1,21]],"date-time":"2017-01-21T16:09:07Z","timestamp":1485014947000},"page":"299-304","source":"Crossref","is-referenced-by-count":25,"title":["Myocardial Recovery Strategy with Decommissioning for the HeartWare Left Ventricular Assist Device"],"prefix":"10.1097","volume":"63","author":[{"given":"Guy A.","family":"MacGowan","sequence":"first","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Wrightson","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Robinson-Smith","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Woods","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Gould","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Schueler","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230821","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1161\/CIRCULATIONAHA.109.933960","article-title":"Reversal of severe heart failure with a continuous-flow left ventricular assist device and pharmacological therapy: a prospective study.","volume":"123","author":"Birks","year":"2011","journal-title":"Circulation"},{"issue":"9 suppl","key":"R2-20230821","first-page":"I32","article-title":"Myocardial recovery using ventricular assist devices: prevalence, clinical characteristics, and outcomes.","volume":"112","author":"Simon","year":"2005","journal-title":"Circulation"},{"key":"R3-20230821","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.jacc.2016.07.743","article-title":"Cardiac recovery during long-term left ventricular assist device support.","volume":"68","author":"Wever-Pinzon","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"R4-20230821","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.cardfail.2012.08.001","article-title":"Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy.","volume":"18","author":"Boehmer","year":"2012","journal-title":"J Card Fail"},{"key":"R5-20230821","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1016\/j.jacc.2012.06.062","article-title":"Myocardial recovery and the failing heart: myth, magic, or molecular target?","volume":"60","author":"Mann","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"R6-20230821","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1093\/ejcts\/ezs585","article-title":"An alternative approach to explantation and exchange of the HeartWare left ventricular assist device.","volume":"43","author":"Sajjad","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"R7-20230821","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1161\/CIRCULATIONAHA.109.933960","article-title":"Reversal of severe heart failure with a continuous-flow left ventricular assist device and pharmacological therapy: a prospective study.","volume":"123","author":"Birks","year":"2011","journal-title":"Circulation"},{"key":"R8-20230821","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/j.healun.2014.09.015","article-title":"Ventricular reconditioning and pump explantation in patients supported by continuous-flow left ventricular assist devices.","volume":"34","author":"Frazier","year":"2015","journal-title":"J Heart Lung Transplant"},{"key":"R9-20230821","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.healun.2015.02.002","article-title":"Percutaneous withdrawal of HeartWare HVAD left ventricular assist device support.","volume":"34","author":"Pettit","year":"2015","journal-title":"J Heart Lung Transplant"},{"issue":"14 suppl","key":"R10-20230821","first-page":"S94","article-title":"Prediction of cardiac stability after weaning from left ventricular assist devices in patients with idiopathic dilated cardiomyopathy.","volume":"118","author":"Dandel","year":"2008","journal-title":"Circulation"},{"key":"R11-20230821","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1093\/eurheartj\/ehq353","article-title":"Heart failure reversal by ventricular unloading in patients with chronic cardiomyopathy: criteria for weaning from ventricular assist devices.","volume":"32","author":"Dandel","year":"2011","journal-title":"Eur Heart J"},{"key":"R12-20230821","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1016\/j.jacc.2013.01.072","article-title":"Magnitude and time course of changes induced by continuous-flow left ventricular assist device unloading in chronic heart failure: insights into cardiac recovery.","volume":"61","author":"Drakos","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"R13-20230821","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1751-7133.2012.00302.x","article-title":"Hemodynamic, echocardiographic, and exercise-related effects of the HeartWare left ventricular assist device in advanced heart failure.","volume":"19","author":"McDiarmid","year":"2013","journal-title":"Congest Heart Fail"},{"key":"R14-20230821","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1161\/CIRCHEARTFAILURE.111.962142","article-title":"Effects of continuous-flow versus pulsatile-flow left ventricular assist devices on myocardial unloading and remodeling.","volume":"4","author":"Kato","year":"2011","journal-title":"Circ Heart Fail"},{"key":"R15-20230821","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1161\/CIRCULATIONAHA.106.633180","article-title":"Cardiac improvement during mechanical circulatory support: a prospective multicenter study of the LVAD Working Group.","volume":"115","author":"Maybaum","year":"2007","journal-title":"Circulation"},{"key":"R16-20230821","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.hlc.2014.04.259","article-title":"Normalisation of haemodynamics in patients with end-stage heart failure with continuous-flow left ventricular assist device therapy.","volume":"23","author":"Gupta","year":"2014","journal-title":"Heart Lung Circ"},{"key":"R17-20230821","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.healun.2015.10.022","article-title":"Development of de novo aortic valve incompetence in patients with the continuous-flow HeartWare ventricular assist device.","volume":"35","author":"Bhagra","year":"2016","journal-title":"J Heart Lung Transplant"},{"key":"R18-20230821","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.healun.2016.08.006","article-title":"Impact of aortic valve closure on adverse events and outcomes with the HeartWare ventricular assist device.","volume":"36","author":"Dobarro","year":"2017","journal-title":"J Heart Lung Transplant"}],"container-title":["ASAIO Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00002480-201705000-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T01:24:24Z","timestamp":1692667464000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00002480-201705000-00012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/mat.0000000000000523","relation":{},"ISSN":["1058-2916"],"issn-type":[{"value":"1058-2916","type":"print"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}