Background: Cardiac transplantation continues to be a limited option for patients with end-stage congestive heart failure (CHF) due to donor shortages. Recent clinical reports and supporting scientific research suggest that some patients with idiopathic dilated cardiomyopathy (IDC) may recover ventricular function and avoid or delay transplantation. We report our early results of patients with IDC and planned bridge to recovery. Methods: Four patients with IDC and severe end-stage CHF were referred for treatment. All were men, ages 38 to 71 years, with a history of IDC (> 10 years), recent moderate to severe mitral regurgitation and NYHA functional Class IV despite maximal medical therapy. All required continuous or intermittent inotropic infusions, one had cardiogenic shock and one-remained anaerobic at rest prior to surgery. All had mitral valve repair and planned insertion of Thoratec left ventricular assist device (LVAD). Recovery time on LVAD ranged from 7 to 17 weeks and included aggressive medical and physical therapy. All patients had ventricular reduction at the time of LVAD removal. Results: Serum plasma norepinephrine and tumor necrosis factor levels returned to normal. All were successfully weaned and there were no complications. Follow-up ranges from 16 to 257 days. All patients remain NYHA functional Class I.TableConclusion: Longer follow-up is needed but our early results suggest that left ventricular recovery is possible in patients with IDC. LVAD planned bridge to recovery may be an alternative to transplantation.