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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