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Left ventricular assist devices (LVAD) are increasingly used in patients with advanced heart failure, and available devices and surgical techniques have strongly evolved over time. Adequate recompensation of patients before surgery is important for optimal surgical outcomes. However, patients with terminal heart failure frequently suffer from cardiorenal syndrome, which complicates recompensation by medical means. Here, we report on the use of an Impella 5.5 microaxial pump for supporting a patient with severely decompensated heart failure before LVAD implantation, which resulted in hemodynamic stabilization and effective recompensation prior to surgery., Competing Interests: Declaration of competing interest TK and JSH have nothing to disclose related to this article. JTS received travel support from Abiomed. AS received speaker honoraria and travel support from Abiomed. JB received honoraria for lectures and/or consulting from: Novartis, BMS, Pfizer, Vifor, Bayer, Servier, Orion, CVRx, MSD, Boehringer Ingelheim, AstraZeneca, Abiomed, Abbott, Medtronic; and institutional research support from Zoll, CVRx, Bayer, Vifor, Abiomed, Medtronic. GD and JDS are consultants to Abbott and Medtronic. LCN received research funding, lecture, consulting and proctoring honoraria and travel support from Abiomed and lecture honoraria from Abbott, Maquet and Orion. Other relationships beyond the topic of this letter exist., (Copyright © 2020 Elsevier Inc. All rights reserved.)

aVAD (ReliantHeart Inc, Houston, TX) is a new, compact, axial flow left ventricular assist device with novel features including real flow measurement, remote device monitoring, and a miniaturized pump housing. The aVAD received Conformité Européenne marking in August 2016. The use of this device was performed in a 61-year-old woman with severe heart failure. Following uneventful surgery, the patient recovered and was successfully discharged from the hospital., (Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Left ventricular non-compaction (LVNC) is a rare cardiac disorder characterized by prominent trabeculae and deep recesses of the ventricular myocardium. Patients with LVNC may develop severe congestive heart failure refractory to medical therapy. However, heart transplantation is strongly limited due to donor organ shortage. Thus mechanical circulatory support by left ventricular assist devices (LVADs) is a promising alternative. Nevertheless, hypertrabeculation and proarrhythmogenic potential in LVNC might represent important hurdles for success of LVAD therapy in these patients., Methods and Results: We retrospectively analyzed the data of a total of 5 patients (3 HVAD, Heartware®; 2 HeartMate II, Thoratec®) with LVNC who underwent LVAD implantation in our institution between 2010 and 2014. Mean follow-up time was 86.5weeks. 30-day survival was 100% without major intrahospital complications. During follow-up, 3 patients developed pump thrombosis requiring pump replacement. Arrhythmias were not detected during follow-up as assessed by ICD interrogation., Conclusions: LVAD implantation in LVNC can be performed with low intrahospital complication rates. However, we observed a high incidence of pump thrombosis during follow-up, possibly related to thromboembolic predisposition by the underlying LVNC. Therefore, careful management of anticoagulation appears to be critical in these patients., (Copyright © 2015. Published by Elsevier Ireland Ltd.)