Myocardial recovery during mechanical circulatory support: weaning and explantation criteria

For selected patients ventricular assist device explantation is feasible. Freedom from heart transplantation and VAD support for >15 years following VAD removal is possible even if recovery is incomplete and the underlying cause for ventricular assist device implantation was a chronic form of cardiomyopathy. Echocardiography and rightheart catheterization are necessary to assess cardiac recovery. However, to date there is no gold standard for recovery assessment. Certain echocardiography parameters appeared highly predictive for long-term (≥5 years) post-weaning cardiac function and reliable for weaning decisions.