Use of mechanical circulatory support in acute circulatory collapse at immediate risk of death after endomyocardial biopsy

There are various indications for a mechanical circulatory support (MCS) devices implantation. We report a case of the use of the MCS in a 39 year old male with acute circulatory collapse and at immediate risk of death after endomyocardial biopsy in order to keep the patient alive until intrinsic cardiac function recovers sufficiently to remove the MCS. The patient underwent an implantation of the left ventricular assist device according to progressive decline of the cardiac function due to a heart muscle disease. With successful regression of heart failure symptoms and reverse remodeling of LV, the device was explanted after four month. Evidence of myocardial reverse remodeling and functional improvement during MCS in our patient proved the use of mechanical ventricular unloading as a therapeutic strategy aimed at cardiac recovery, allowing removal of the MCS device instead of extending his use as a bridge to heart transplantation.