A large clinical-genetic study has unravelled novel genotype-to-phenotype correlations in HCM and DCM which warrant future investigation of both the underlying mechanisms and the prognostic use.

Because women were referred with more severe heart failure but fewer relative contraindications, it seems that the option of transplantation is less intensely considered for women, particularly for those with comorbidities, by the referring physicians. Because women with DCM do as well as men after transplantation, efforts should be undertaken to improve referral of women.

Little is known about the hemolysis rate in the case of concomitant implantation of two continuous flow pumps for the treatment of biventricular heart failure. We present a retrospective study comparing the hemolysis parameters in patients supported with one implantable centrifugal pump of the type HeartWare HVAD used as a left ventricular assist device (LVAD) and with two pumps as a biventricular assist device (BiVAD). A total of 20 consecutive patients who received HeartWare BiVAD (n = 10) and LVAD (n = 10) support at our institution between September 2009 and September 2010 were examined. Hemolysis- and anemia-related parameters were analyzed after 2 weeks, 5 weeks, 3 months, and 6 months of support. Preoperative levels of hemoglobin, lactate dehydrogenase (LDH), and total bilirubin were similar in both groups. There were no differences in LDH, plasma-free hemoglobin (fHB), or total bilirubin levels postoperatively for up to 6 months. Only the haptoglobin level was lower in BiVAD recipients up to 3 months after surgery: 2nd week (63.5 [range: 8-237] mg/dl vs. 151 [range: 11-263] mg/dl, p = 0.05), 5th week (67 [range: 8-196] mg/dl vs. 215 [range: 56-292] mg/dl, p = 0.046), and after 3rd month (42 [range: 8-205] mg/dl vs. 220 [range: 157-256] mg/dl, p = 0.048). Our retrospective analysis of BiVAD HeartWare and LVAD HeartWare recipients showed a lack of a clinically important degree of hemolysis when two centrifugal HeartWare pumps are used for biventricular support.

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During biventricular assist device (BVAD) support, right ventricular (RV) assistance may restore sufficient RV function after several weeks to months. Since November 2009, 10 patients (9 men and 1 woman; mean age, 49.7 ± 14.4 y) suffering from idiopathic dilatative cardiomyopathy received BVAD employing two implantable continuous-flow pumps of the HeartWare type. In three male patients, aged 53, 57, and 60 years, after a right ventricular assist device (RVAD) support time of 15.6, 11.2, and 3.6 months, respectively, the RVAD was stopped, and the percutaneous lead was surgically shortened in two cases. There were no differences in preoperative RV geometry and function or in severity of tricuspid valve regurgitation in patients with and without delayed RV recovery. Follow-up echocardiography revealed no regurgitation through the right pump in any patient. One patient died due to severe sepsis 63 days later; the other two patients are currently on left ventricular assist devices support at home, 120 and 236 days after RVAD deactivation with stable hemodynamic conditions and without any thromboembolic events. RV function may recover even after weeks or months on BVAD support. The HeartWare HVAD used as an RVAD may be stopped and left in place without complications.