Left ventricular assist device as a bridge to partial left ventriculectomy

Abstract

In 1963, Dr Michael DeBakey successfully implanted the first left ventricular assist device. Throughout the 1970s, cardiovascular research aimed to achieve long-term circulatory support with such devices; later, as improved medical therapy decreased patients' chances of organ rejection or infection, transplantation became a viable alternative for the treatment of heart failure. At that point, left ventricular assist devices began to be used as bridges to transplantation. As left ventricular assist devices were used for longer periods of time, we realized that the ventricular function and overall health of the patients awaiting transplant improved. Used as a bridge to transplantation, left ventricular assist devices often increased a patient's chances of survival and recovery. Recently left ventricular assist devices have been used as bridges to partial left ventriculectomy (the Batista procedure). Our early experiences with this procedure in selected patients have been promising. Many patients recover to NYHA functional class I after prolonged left ventricular unloading, surgery, or both. In addition, the native heart may be saved, especially in younger patients, eliminating the need for transplantations and decreasing the strain on the limited organ donor pool.