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Updated: Aug 8, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Heart substitution: transplantation and total artificial heart. The Texas Heart Institute experience
Insights
Cardiac transplantation significantly improves survival for end-stage heart disease patients. The total artificial heart (TAH) serves as a crucial bridge to transplantation for emergency cases, demonstrating a feasible two-stage approach.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Cardiac transplantation and total artificial heart (TAH) are established heart substitution methods.
- Cyclosporine has significantly improved survival rates for cardiac transplant recipients.
- Cardiac transplantation is not suitable for emergency postcardiotomy scenarios.
Purpose of the Study:
- To evaluate the efficacy of cardiac transplantation and the role of TAH as a bridge to transplantation.
- To assess the outcomes of cardiac transplantation at the Texas Heart Institute.
- To demonstrate the feasibility of a two-stage approach using TAH followed by transplantation.
Main Methods:
- Retrospective review of 25 cardiac transplantations performed between July 1982 and May 1984.
- Analysis of two cases where TAH was used as a temporary measure before transplantation.
- Assessment of patient survival and functional status post-transplantation.
Main Results:
- Nineteen out of 25 patients (76%) are alive and in Functional Class I, leading normal lives.
- TAH functioned effectively in two emergency cases, maintaining circulation until donor hearts were available.
- The two-stage TAH-to-transplantation strategy proved successful.
Conclusions:
- Cardiac transplantation, particularly with cyclosporine, offers excellent long-term survival and functional recovery.
- The total artificial heart is a viable option for temporary circulatory support in critical situations, enabling subsequent transplantation.
- Further development of cardiac prostheses is encouraged based on the success of this two-stage approach.
Abstract:
Two methods of heart substitution have been used at the Texas Heart Institute: cardiac transplantation and the total artificial heart (TAH). Cardiac transplantation is an effective means of saving patients with endstage heart disease and, since the introduction of the immunosuppressive agent cyclosporine, survival has increased significantly. In a recent series from July 1982 to May 1984, 25 patients underwent cardiac transplantation at the Texas Heart Institute. Nineteen of these patients are alive, in Functional Class I, and leading normal lives. A major disadvantage of cardiac transplantation is that it cannot be used on an emergency basis for postcardiotomy patients. In this situation, TAH has been used twice (1969 and 1981) as the first stage to maintain circulation prior to subsequent cardiac transplantation. In both instances, the TAH functioned well until a satisfactory donor was found. This demonstrates the feasibility of the two-staged concept and encourages further development of cardiac prostheses.
