Patients who Have Dilated Cardiomyopathy Must Have a Trial of Bridge to Recovery (Pro)

This article documents the experience that mechanical unloading of a diseased heart by application of a left ventricular assist device showing the consequence of functional improvement and weaning thereafter is a realistic option. The patient who has been weaned first is still doing fine with sufficient and stable cardiac function more than 10 years after device removal. Furthermore, it is discussed how to identify potential patients for weaning, what problems may arise, how the follow-up should be designed, the medication before and after weaning, the surgical procedure, and the general management. Moreover, the authors outline the difficulties that result from the gene and protein expression analysis of the diseased myocardium when compared to the cardiac function.