SynCardia temporary total artificial heart as bridge to transplantation: current results at la pitié hospital.

Details

Serval ID
serval:BIB_728C6A3C3D9B
Type
Article: article from journal or magazin.
Collection
Publications
Title
SynCardia temporary total artificial heart as bridge to transplantation: current results at la pitié hospital.
Journal
The Annals of thoracic surgery
Author(s)
Kirsch M.E., Nguyen A., Mastroianni C., Pozzi M., Léger P., Nicolescu M., Varnous S., Pavie A., Leprince P.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Publication state
Published
Issued date
05/2013
Peer-reviewed
Oui
Volume
95
Number
5
Pages
1640-1646
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The SynCardia temporary total artificial heart (t-TAH) provides complete circulatory support by replacing both native cardiac ventricles and all cardiac valves.
We performed a retrospective analysis of demographics, clinical characteristics and survival of patients bridged to transplantation using the SynCardia t-TAH (SynCardia Systems Inc, Tucson, AZ).
From 2000 to 2010, the SynCardia t-TAH was implanted in 90 consecutive patients (80 males; mean age, 46 ± 13 years) suffering cardiogenic shock secondary to idiopathic (n = 40, 46%) or ischemic (n = 24, 27%) cardiomyopathy or other causes. Before implantation, 7 (9%) patients had cardiac arrest, 27 (33%) were on ventilator, and 18 (22%) were on extracorporeal life support. Pre-implant creatinine values were 1.7 ± 0.97 mg/dL and total bilirubin levels were 45 ± 32 μmol/L; mean duration of support was 84 ± 102 days. Thirty-five (39%) patients died while on support after a mean of 62 ± 107 days. Actuarial survival on device was 74% ± 5%, 63% ± 6%, and 47% ± 8% at 30, 60, and 180 days after implantation. While on support, 9 (10%) patients suffered stroke, 13 (14%) had mediastinitis, and 35 (39%) required surgical reexploration for bleeding, hematoma, or infection. Multivariate analysis revealed that older recipient age and preoperative mechanical ventilation were risk factors for death while on support. Fifty-five (61%) patients were transplanted after a mean of 97 ± 98 days of support. Actuarial survival rates were 78% ± 6%, 71% ± 6%, and 63% ± 8% at 1, 5, and 8 years after transplantation.
The SynCardia t-TAH provided acceptable survival to transplantation rates with a remarkably low incidence of neurologic events. Posttransplant survival was similar to that of patients undergoing primary heart transplantation in France.
Keywords
Adult, Age Factors, Aged, Female, Heart Transplantation/mortality, Heart, Artificial, Humans, Logistic Models, Male, Middle Aged, Respiration, Artificial, Retrospective Studies, Risk Factors
Pubmed
Web of science
Create date
28/03/2019 17:47
Last modification date
20/08/2019 14:30
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