20.500.12556/RUL-190599 Case report decommissioning of a left ventricular assist device following reverse remodeling in non-ischemic cardiomyopathy patient Background Left ventricular assist devices (LVAD) improves clinical outcomes in patients with advanced heart failure (HF) and may induce myocardial recovery. LVAD explantation remains underutilized due to challenges in identifying patients with true recovery potential. We describe a case of a patient with advanced HF due to myocarditis, who underwent LVAD implantation and after reverse structural remodelling facilitated by a structural recovery protocol, LVAD weaning was possible. Case presentation A patient presented with an advanced HF due to myocarditis. Despite receiving guidelinedirected medical therapy (GDMT) and levosimendan, left ventricular function failed to improve and the patient remained inotrope dependent. The patient was approved and listed for heart transplant. Due to progressive worsening despite inotropic support, the patient underwent LVAD HeartMate II implantation. Through optimized mechanical unloading, GDMT, and structured follow-up, echocardiography demonstrated progressive cardiac reverse remodelling and LVAD decommissioning was feasible. Conclusion Despite low explantation and decommissioning rates in registries, dedicated recovery programs demonstrate that through combining mechanical unloading and GDMT optimization, sustained recovery and LVAD weaning are possible. This strategy offers a valuable alternative to transplantation and highlights the importance of standardized protocols in identifying and managing recovery candidates. case report guideline directed medical therapy heart failure LVAD decommissioning myocardial recovery ptikaz primera s smernicami podprto zdravljenje z zdravili srčno popuščanje izključitev mehanične podpore levega prekata izključitev LVAD okrevanje miokarda izboljšanje delovanja srčne mišice true false true Angleški jezik Slovenski jezik Članek v reviji 2026-10-30 08:46:55 2026-10-30 08:46:59 2026-10-31 04:34:07 0000-00-00 00:00:00 2026 0 0 775 iss. 1 , art. 775 Vol. 21 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1-089 1749-8090 10.1186/s13019-026-04609-5 287894531 RAZ_Ugovsek_Sabina_2026.pdf RAZ_Ugovsek_Sabina_2026.pdf 1 8AA59FB0227A0ECDE947A3AAFDD7F993 0a407c588ad34821f87659ec972c8eba077d20196ada8ec2e22cc284dced458f 24b5f0d5-d436-11f1-aea2-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=252126 https://link.springer.com/article/10.1186/s13019-026-04609-5 1 0f4c72da-d436-11f1-aea2-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=252125 Medicinska fakulteta 0 0 0