Characteristics of LVAD Turn-Down Study to Predict Myocardial Recovery and Successful LVAD Decommissioning

Purpose Myocardial recovery after left ventricular device (LVAD) implantation is important to identify; however, identifying predictors of successful LVAD decommissioning, and recurrence of heart failure remains a challenge. Methods We performed a retrospective analysis on individuals who underwent a protocolized echocardiographic and invasive hemodynamic turn-down study. Patients were selected based on normalized hemodynamics, clinical stability and LVEDD Results A total of 12 patients underwent the LVAD weaning protocol. Of those patients, 42% (5/12) underwent LVAD decommissioning with sustained recovery (SR) (median 13 months) while 58% (7/12) failed recovery (FR) by requiring LVAD re-implantation after decommissioning or failed turn-down study precluding LVAD decommission. In FR versus SR patients LV-end systolic (LVESD) and -end diastolic (LVEDD) diameter were higher at the start (LVESD 4.8 ± 0.4 FR vs 3.5 ± 0.3 SR, p Conclusion In our cohort of LVAD turn-down studies, we were able to identify echo parameters, invasive hemodynamics, and LVAD pump parameters that differed between patients with failed and sustained recovery.