Around and around the merry-go-round: multiple implantations of short- and long-term ventricular assist devices in a patient with severe heart failure.

Multiple implantations of left ventricular assist devices over a period of three years were performed in a 17-year-old gentleman with non-ischaemic dilated cardiomyopathy and congestive cardiac failure. The first device (HeartMate II) was implanted as a bridge to transplantation. However, after few months of support the patient showed signs of myocardial recovery and the device was successfully explanted. After 2 years of uneventful follow-up, the patient's condition deteriorated requiring further mechanical support. Due to the elevated risk associated with a redo full-support LVAD implantation, we decided to implant a partial support device (Synergy CircuLite). Because of recurrent pump thrombosis requiring device exchange, the final weeks to transplantation were bridged with CentriMag short-term LVAD. After successful cardiac transplantation the patient required further temporary extracorporeal membrane oxygenation support which was weaned off and explanted on the fourth postoperative day. After further uncomplicated postoperative recovery the patient was discharged and has been doing well for 1 year of follow-up.