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Total artificial heart: survival and complications
C Muneretto1, E Solis, A Pavie
1Department of Cardio-Thoracic Surgery, La Pitié Hospital, Paris, France.
The Annals of Thoracic Surgery
|January 1, 1989
Summary
Total artificial heart (TAH) implantation served as a bridge to transplantation in 28 patients. Early TAH use is recommended for acute cardiac failure, but contraindicated in immunosuppressed individuals due to infection risks.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Devices
Background:
- End-stage heart failure necessitates advanced mechanical circulatory support.
- Total artificial hearts (TAHs) offer a temporary solution, bridging patients to heart transplantation.
- The Jarvik-7 TAH has been utilized in various clinical scenarios.
Purpose of the Study:
- To evaluate the outcomes of TAH implantation as a bridge to transplantation.
- To compare the performance of different sized Jarvik-7 TAH devices.
- To identify risk factors and contraindications for TAH use.
Main Methods:
- Retrospective analysis of 28 patients receiving TAH implantation.
- Utilized 70-mL and 100-mL Jarvik-7 TAH devices.
- Monitored for complications such as thromboembolism, bleeding, sepsis, and organ failure.
Main Results:
- Mean mechanical support duration was 14.8 days.
- No significant differences in survival or complications between 70-mL and 100-mL Jarvik-7 groups.
- Successful transplantation in 11 patients; 1 remains on support.
- Sepsis and multiple-organ failure were primary causes of mortality.
- Patients receiving TAH for post-transplant rejection died from infection.
Conclusions:
- TAH implantation is a viable bridge to transplantation for select patients with acute cardiac failure.
- Early TAH implantation may benefit younger and older patients with severe cardiac conditions.
- Contraindication for TAH in immunosuppressed patients is crucial due to high infection risk.