[Successful bridge transplantation with the Vienna artificial heart]

The Vienna Heart, a pulsatile artificial ventricle, vacuum-formed from Pellethane has been used successfully as total artificial heart (TAH) and left ventricular assist device (LVAD) to bridge over patients in terminal heart failure. A 50 year-old patient with cardiomyopathy had to be resuscitated and was transferred in cardiogenic shock, with impaired renal and liver function. 6 days after orthotopic implantation of a Vienna TAH a suitable donor organ was found and the patient was transplanted. 7 weeks later he was discharged and is alive and well now. A 40-year-old patient was transferred in cardiogenic shock 22 days after recurrent anterior infarction. Due to renal failure he was on haemofiltration. Congestive liver failure caused a severe coagulation disorder so a Vienna LVAD was implanted without the use of extracorporeal circulation. Despite development of septicaemia he was transplanted 24 days later. It was thought that either the ventricular thrombus or the LVAD was the septic focus. All consecutive blood cultures have been negative and he was discharged 6 weeks later. To our knowledge, case 1 represents the first successful bridging with a non-Jarvic TAH. The second case shows that sepsis is not necessarily a contraindication to heart transplantation.