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Infections with the CardioWest total artificial heart

F A Arabía1, J G Copeland, R G Smith

  • 1Section of Cardiovascular and Thoracic Surgery, University of Arizona Health Science Center, Tucson 85724-5071, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 6, 1998
PubMed
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The CardioWest total artificial heart serves as a bridge to heart transplantation, significantly reducing infection-related mortality compared to previous studies. This advancement enhances patient survival rates in critical cardiac care.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Transplantation Medicine

Background:

  • The CardioWest total artificial heart (TAH) is a device designed to replace failing ventricles.
  • It is utilized as a bridge to heart transplantation in select US centers under FDA investigation.

Purpose of the Study:

  • To evaluate the outcomes of patients receiving the CardioWest TAH as a bridge to heart transplantation.
  • To assess the incidence and impact of infectious complications in this patient population.

Main Methods:

  • Twenty-seven patients with end-stage heart failure underwent TAH implantation between 1993 and an unspecified date.
  • Inclusion criteria: heart transplant candidacy, cardiac index < 2.0 L/min/m2, and maximal inotropic support.
  • Infections were categorized as systemic or local; outcomes including transplantation and survival were recorded.

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Main Results:

  • Twenty-five of 27 patients (92.6%) successfully bridged to transplantation and were discharged.
  • Two deaths occurred: one from mechanical failure, one from infection (mediastinitis), resulting in a 3.7% infection-attributable mortality.
  • Infectious complications were common (64 infections across 24 patients), but mortality from infection was substantially lower than historical rates (3.7% vs. up to 40%).

Conclusions:

  • The CardioWest TAH is effective in bridging patients to heart transplantation with a high survival rate.
  • Improved patient selection, management strategies, and infection control have significantly reduced TAH-related mortality.
  • Infectious complications remain a concern, but current protocols mitigate their impact on overall survival.