Total artificial heart and physical therapy management.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Physical Therapy

Background:

• The Total Artificial Heart (TAH) serves as a critical bridge to heart transplantation (BTT) for end-stage heart failure patients.
• Left Ventricular Assist Devices (LVADs) are another form of mechanical circulatory support, offering portability and home discharge capabilities.

Purpose of the Study:

• To detail the SynCardia CardioWest Temporary TAH system as a BTT option.
• To outline physical therapy management strategies for TAH recipients.
• To compare TAH management with that of LVADs.

Main Methods:

• Descriptive analysis of the TAH device and its implantation.
• Review of physical therapy interventions for TAH patients.
• Comparative analysis of TAH and LVAD characteristics and patient management.

Main Results:

• The CardioWest TAH is the sole FDA-approved TAH for BTT, involving cardiectomy to mitigate complications like pulmonary hypertension and right heart failure.
• Both TAH and LVADs support exercise adaptation by increasing cardiac output.
• TAH management requires close attention to ventricular fill volumes and necessitates inpatient physical therapy due to the large driver console, unlike portable LVADs.

Conclusions:

• Despite mechanical distinctions, physical therapists can effectively manage TAH patients using established guidelines for heart failure and mechanical circulatory support.
• Cardiectomy in TAH eliminates the possibility of electrocardiography, telemetry, and native pulse rate monitoring.