Myocardial Recovery Program

Helping your heart recover while an LVAD supports it

The Myocardial Recovery Program at Banner – University Medical Center Tucson is for people living with a left ventricular assist device (LVAD), a mechanical pump implanted alongside the heart that takes over much of the work of pumping blood. The goal is to help the heart muscle grow stronger while the pump supports it, using careful monitoring, medicines and specialized testing.

In some patients, the heart muscle improves over time. The program looks carefully for signs of recovery and supports the heart’s ability to heal, with safety always the first priority. For selected patients, recovery can mean turning down the LVAD’s support or removing the pump altogether.

Refer a patient

What the program offers:

• Recovery-focused care planned for each patient
• Advanced imaging and hemodynamic assessment, which measures pressure and blood flow inside the heart
• Heart failure medicines adjusted to guideline-recommended targets
• Structured protocols for adjusting LVAD speed and weaning support

Who the program is for

People with an LVAD whose heart function may be improving, or who want to be evaluated for their potential to recover.

The goal

To strengthen the heart safely and, in selected patients, to find out whether LVAD support can be reduced or the device removed.

Recovery looks different for every patient. Even a small improvement in heart function can ease symptoms and improve energy and quality of life.

Pairing LVAD support with intensified heart failure medicines is an approach Carl Tong, MD-PhD, calls myocardial repair. The pump rests, or unloads, the weakened heart muscle while the medicines help it heal.
 

Heart failure stages

Heart failure usually develops in stages. It moves from risk factors (Stage A), to changes in the heart without symptoms (Stage B), to heart failure with symptoms (Stage C), to advanced heart failure that continues despite treatment (Stage D). LVAD-supported recovery is considered for patients with advanced heart failure.

Many conditions and diseases can cause heart failure, including:

• Aging
• Cancer treatment
• Cardiovascular disease
• Endocrine disorders
• Infections, such as COVID-19
• Mutations
• Pregnancy
• Stress
• Toxicities

What to expect

Careful heart assessment

Your care team tracks how your heart is responding with:

• Repeated echocardiograms, ultrasound images of the heart taken through the chest wall (serial transthoracic echocardiography)
• Right heart catheterization, which measures pressures inside the heart through a thin tube
• Exercise and functional testing
• Blood biomarkers and other laboratory tests

Heart medicines

• Guideline-directed heart failure medicines
• Afterload reduction: medicines that lower the resistance the heart has to pump against
• Monitoring for heart rhythm problems, and treatment when needed

LVAD adjustments

• Pump speed optimized according to a set protocol
• Gradual changes to how much of the heart’s work the pump takes over
• Weaning trials guided by pressure measurements inside the heart, to test how well the heart performs with less pump support

Your care team

Specialists in advanced heart failure cardiology, cardiac surgery, cardiac imaging, nursing, rehabilitation and transplant work together on each patient’s plan.

You are part of the team

Education, shared decision-making and scheduled follow-up help patients understand the goals, what to expect and the safety considerations at each step.

Research

Patients may have the opportunity to take part in clinical research that aims to define who recovers, why their hearts recover and how they do afterward.

Leadership

The program is led by Carl Tong, MD-PhD, clinical professor of medicine at the University of Arizona College of Medicine – Tucson and medical director of heart failure at Banner – UMC Tucson. Tong is a physician-scientist who specializes in advanced heart failure and transplant cardiology. Before coming to Tucson, he helped rescue a new heart transplant program and start a new LVAD program in Texas. His research includes LVAD heart recovery, noninvasive monitoring devices and new treatments based on the heart’s contractile proteins.

Your clinical pathway

Step 1: Referral

You or your doctor request an evaluation through the Banner – University Medical Center Tucson advanced heart failure team.

Step 2: Evaluation

The team uses heart imaging, laboratory tests and sometimes catheter-based measurements to understand your heart’s potential to recover.

Step 3: Recovery plan

Your team adjusts your medicines and LVAD settings and follows your progress closely over time.

Step 4: Reassessment

If your heart keeps improving, you and your team discuss next steps. These may include continued long-term support, reduced LVAD support or, in selected cases, removal of the device.

Possible benefits

Recovery can bring:

• A smaller, stronger left ventricle, the heart’s main pumping chamber
• Fewer heart failure symptoms
• Better exercise tolerance and quality of life
• For selected patients, eligibility to have the LVAD removed (explantation)

Not every patient will be a candidate for having the device removed. Even partial recovery can bring meaningful clinical benefits and help guide long-term care.

Referrals and consultations

The program welcomes referrals for LVAD patients with suspected or potential myocardial recovery.

Patients can ask their cardiologist or LVAD team about a referral.

Email: AdvancedHF@bannerhealth.com
Phone: 520-694-6299
Fax: 520-694-2692