MECHANICAL SUPPORT IN DILATED CARDIOMYOPATHY - SIGNS OF EARLY LEFT-VENTRICULAR RECOVERY

Background. Recent reports have documented left ventricular recovery i n patients with dilated cardiomyopathy off-loaded long term with a lef t ventricular assist device. We sought to document the natural history of left ventricular recovery. Methods. We implanted the TCI left vent ricular assist device without the intention to perform transplantation in 2 patients with dilated cardiomyopathy who had been rejected for t ransplantation. Both were in New York Heart Association functional cla ss IV and had renal failure. One was a diabetic. We studied left ventr icular function with detailed echocardiography at 4, 6, and 8 weeks po stoperatively. Results. With the left ventricular assist device turned off, we observed a progressive increase in myocardial contractility b eginning as early as 4 weeks after implantation and improving progress ively. Histologic examination showed resolution of myocytolysis in bot h patients. Conclusions. Left ventricular recovery begins earlier than was previously suspected. Mechanical bridge to myocardial recovery is a potential approach to therapy for such patients. (C) 1997 by The So ciety of Thoracic Surgeons.