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

Détails

ID Serval
serval:BIB_728C6A3C3D9B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
SynCardia temporary total artificial heart as bridge to transplantation: current results at la pitié hospital.
Périodique
The Annals of thoracic surgery
Auteur(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
Statut éditorial
Publié
Date de publication
05/2013
Peer-reviewed
Oui
Volume
95
Numéro
5
Pages
1640-1646
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
28/03/2019 17:47
Dernière modification de la notice
20/08/2019 14:30
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