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Implantation of the Syncardia Total Artificial Heart
16:11

Implantation of the Syncardia Total Artificial Heart

Published on: July 17, 2014

[Current problems in the surgical treatment of acquired heart disease]

S Kitamura, A Miyamoto, S Shindo

    Nihon Geka Gakkai Zasshi
    |September 1, 1985
    PubMed

    Insights

    Patients with ischemic heart disease and valvular heart disease undergoing combined surgeries face significant mortality risks. However, simultaneous treatment for coronary artery and other vascular diseases poses similar risks to patients without ischemic heart disease.

    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Surgery Outcomes
    • Medical Device Evaluation

    Context:

    • Analysis of surgical outcomes for patients with complex cardiovascular conditions.
    • Evaluation of combined surgical procedures involving coronary artery disease and valvular or peripheral vascular disease.
    • Assessment of specific prosthetic valves for tricuspid valve replacement.

    Purpose:

    • To report on the early and late mortality rates of combined valvular/coronary artery surgery, coronary artery/peripheral vascular surgery, and tricuspid valve replacement (TVR) with St. Jude Medical (SJM) valves.
    • To compare the risk of late obstructive syndrome (LOS) in patients undergoing simultaneous surgical treatment for coronary artery disease and other vascular conditions.
    • To evaluate the suitability of the SJM valve for TVR.

    Summary:

    • Combined valvular and coronary artery surgery had a 26% early and 21% late mortality rate, with 15.8% of late deaths due to LOS.
    • Combined coronary artery and peripheral vascular surgery showed a 43% mortality rate, with one death attributed to LOS.
    • Tricuspid valve replacement with SJM valves had a 15% mortality rate, considered low compared to other valves. Patients undergoing simultaneous treatment for coronary artery disease and other vascular issues had similar LOS risks as those without ischemic heart disease, highlighting the importance of myocardial protection.

    Impact:

    • Findings suggest that while combined surgeries carry risks, simultaneous treatment for coronary artery disease and other vascular conditions may not significantly increase LOS risk.
    • Highlights the critical need for effective myocardial protection strategies in patients with severe left ventricular dysfunction and hypertrophy undergoing these procedures.
    • Identifies the St. Jude Medical valve as the current best option for tricuspid valve replacement based on design and hemodynamic performance, despite the lack of an ideal artificial valve.

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