A 55-year-old man with dilated cardiomyopathy (DCM) showed refractory heart failure despite of optical medical therapy and was admitted to our hospital in July 10, 2012. He was registered as a candidate for heart transplantation in Japan, and underwent implantation of a left ventricular assist device (LVAD) (EVAHEART). During the following period, however, he suffered brain hemorrhagic infarction several times and his cognitive function drastically declined, and he had to be moved from Status 1 to 3. Because his recovery on his cardiac function was simultaneously observed (LVEF; 15 to 45%), we tried to wean from LVAD. During this trial, we assessed change of his hemodynamics through by reducing rotation speed of the centrifugal pump and confirmed that no significant hemodynamic worsening was occurred. We successfully removed his LVAD at 1722 days after LVAD implantation, and he has been stable. Destination therapy by LVAD implantation is not approved in Japan and we report successful withdrawal of LVAD in a case with major cerebrovascular complication and showing late recovery of cardiac function.
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