Pathology in mechanical circulatory support

Pathology services have a vital role for guiding care for and predicting risk in advanced heart failure patients undergoing definitive therapy, including mechanical circulatory support (MCS) and heart transplantation. Pathologists also provide research data to help in the fundamental understanding of heart failure. Analysis of myocardial tissue guides patient management. This chapter offers an overview of pathology services that deliver definitive heart failure therapy care to patients, including MCS. The chapter also reviews the current state of knowledge of myocardial remodeling, reverse remodeling, and of the potential for recovery of ventricular function following durable mechanical support with a left ventricular assist device (LVAD).