Novel Explantation Protocol for Cardiac Recovery and Device Weaning Post-Left Ventricular Assist Device Therapy: A Single-Center Experience

Although some patients may exhibit significant myocardial improvement after the placement of a durable left ventricular assist device (LVAD), there are no established guidelines on determining patients who may be eligible for explantation. In this single-center case series, three patients were evaluated for LVAD explantation 8–24 months after implantation using a rigorous multimodality protocol along with multidisciplinary team discussions to assess appropriateness for explantation. Although two of the patients have remained successful device-free, the third patient ultimately underwent heart transplantation 2 months post-explantation. We propose evaluating this protocol more broadly in patients with durable LVADs who demonstrate improved left ventricular function with the goal of ultimately developing standardized guidelines to assess appropriateness for LVAD explantation.