Remission of chronic, advanced heart failure after left ventricular unloading with an implantable left ventricular assist device

We describe the case of a 35-year-old man with severe, dilated idiopathic cardiomyopathy who was placed on the waiting list for cardiac transplantation. While awaiting transplantation, his heart failure decompensated to such a degree that left ventricular assist device support was necessary. He did well on device support until a pump-pocket infection (methicillin-resistant coagulase-negative staphylococci) developed at 10 months. At that time, echocardiograms showed normal heart size and an ejection fraction of 0.45 to 0.49 without pump support. The pump was, therefore, explanted emergently. The patient has remained clinically stable with preserved ventricular function nearly 13 years after the explantation procedure.