Introduction Left ventricular assist device (LVAD) implantation continues to occur at an exceedingly high rate due to the donor and supply mismatch when it comes to heart transplantation. LVADs however do not come without risk and have high rates of significant bleeding, stroke, pump thrombosis and infection. Most of the clinical and research efforts thus far have been focused on LVAD insertion with the goal of destination therapy or as a bridge to transplant. The goal of bridge to recovery has often been underestimated despite multiple studies showing reverse remodeling of the myocardium. Success rates with regards to device explantation varies from Hypothesis The goal of our study was to analyze all the patients that have received an LVAD at Allegheny General Hospital from the years 2006-2017 (n=277). By looking at different echocardiographic parameters, we identified all patients with the potential for bridge to recovery. We suspected that of our previous LVAD patients, we were missing this responder population who had the potential for LVAD explantation. Methods With our institutions IRB approval, we retrospectively collected echocardiographic data on all LVAD implantations. We focused specifically on the LVEDD (left ventricular end diastolic diameter) and LVEF (left ventricular ejection fraction). We defined responders as those patients with an LVEDD 40% at some point post LVAD implantation. We analyzed echo parameters at pre-LVAD, 1, 3, 6, and 12 months status post LVAD implantation. Results We identified 16 responders (5.7%). Of these 16 responders, 9 were male (56.3%) and 7 were female (43.7%). Of these responders, 50% of them were classified as INTERMACS 1 at the time of LVAD implant. Of these implantations, 69% were Heartmate 2. The average age of the responder patient was 63 years old. Of note, the average responder Pre-LVAD LVEDD was 59 mm and LVEF 15%. Subsequently at 1 month, the average LVEDD was 45 mm and 20%, 3 month LVEDD 42 mm and LVEF 25%, 6 month LVEDD 43 mm and LVEF 25%, 12 month LVEDD 43.5 mm and LVEF 30%. Of the 16 responders, 1 patient proceeded to transplant despite recovery of LVEF. Of the remaining 15 responders, only 5 patients were explanted with 1 patient requiring subsequent listing for transplant. By identifying this patient population of responders, it allows us to aggressively pursue further explantation options for these patients in the future and avoid unnecessary cardiac transplantation and ultimately catastrophic LVAD complications leading to an untimely death. Conclusions The goal of this project was to identify patients who have the potential for bridge to recovery. We want to focus our attention on this option to establish a bridge to recovery program. We hope to improve the quality of life of these patients given we can avoid life threatening complications and improve their overall quality of life that can be similar to a normal healthy adult after explantation. A bridge to recovery program also has the potential to benefit resource utilization for our patients and institution.