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Updated: Nov 25, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Outcomes after heart transplantation and total artificial heart implantation: A multicenter study
Michel Carrier1, Jaime Moriguchi2, Keyur B Shah3
1Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Insights
Temporary total artificial heart (t-TAH) use as a bridge to heart transplantation (HT) in high-volume centers shows satisfactory survival outcomes. This study highlights the viability of t-TAH support for critically ill patients awaiting HT.
Area of Science:
- Cardiology
- Transplantation Medicine
- Mechanical Circulatory Support
Background:
- Heart transplantation (HT) is a critical treatment for end-stage heart failure.
- Temporary total artificial heart (t-TAH) devices serve as a bridge to transplantation for patients awaiting HT.
- Assessing outcomes in high-volume centers is crucial for understanding t-TAH efficacy.
Purpose of the Study:
- To evaluate the outcomes of patients supported with a temporary total artificial heart (t-TAH) as a bridge to heart transplantation (HT).
- To analyze survival rates and adverse events in patients undergoing t-TAH implantation in high-volume centers.
Main Methods:
- Retrospective analysis of 217 consecutive patients who received t-TAH (SynCardia Systems) between January 2014 and May 2019.
- Data collected from 6 high-volume North American centers.
- End points included survival and adverse events post-t-TAH implantation and post-HT.
Main Results:
- 63.5% of patients (138/217) successfully underwent HT.
- Overall survival was 75% at 1 year and 58% at 5 years.
- Post-transplant survival was 88% at 6 months and 74% at 5 years.
- Leading causes of death post-HT included chronic allograft vasculopathy, multiorgan failure, sepsis, and stroke.
Conclusions:
- Nearly two-thirds of patients implanted with a t-TAH proceeded to heart transplantation.
- Survival rates after t-TAH implantation and subsequent HT were satisfactory for critically ill patients.
- t-TAH serves as an effective bridge to transplantation in select high-volume centers.
Background:
We sought to assess the outcomes after heart transplantation (HT) of patients supported with a temporary total artificial heart (t-TAH) as a bridge to transplantation in high-volume centers.
Methods:
A retrospective analysis of 217 consecutive patients who underwent t-TAH (SynCardia Systems, Tucson, Arizona) implantation between January 2014 and May 2019 in 6 high-volume North American centers was performed. End points included survival and adverse events after t-TAH and HT.
Results:
The mean age of patients was 49 ± 12 years, and heart failure etiologies were non-ischemic dilated cardiomyopathy (36%), ischemic (25%), restrictive (12%), and cardiac graft failure (9%). A total of 101 (48%) patients had Interagency Registry for Mechanically Assisted Circulatory Support patient profile 1, and 65 (31%) had Interagency Registry for Mechanically Assisted Circulatory Support patient profile 2. At the end of the study period, 138 of 217 (63.5%) patients had undergone HT, and 75 (34.5%) patients died before HT. The mean time between t-TAH implantation and HT averaged 181 ± 179 days (range: 0-849) and the mean follow-up after HT was 35 ± 25 months. The overall survival in the entire cohort was 75%, 64%, and 58% at 1, 2, and 5 years, respectively. Post-transplant survival was 88%, 84%, 79%, and 74% at 6 months, 1 year, 2 years, and 5 years, respectively. Among the 32 patients (23%) who died after HT, the main causes of death were chronic allograft vasculopathy (25%), multiorgan failure (21.8%), sepsis (15.6%), and stroke (9%).
Conclusion:
In this multicenter study, almost two thirds of patients implanted with a t-TAH could be transplanted. The overall and post-transplantation survival after t-TAH was satisfactory in these critically ill patients.
