Interagency registry for mechanically assisted circulatory support report on the total artificial heart

Arabía, Francisco A.; Cantor, Ryan S.; Koehl, Devin; Kasirajan, Vigneshwar; Gregorič, Igor D.; Moriguchi, J.; Esmailian, F.; Ramzy, Danny; Chung, Joshua; Czer, L.; Kobashigawa, Jon A.; Smith, Richard G.; Kirklin, James K.

doi:10.1016/j.healun.2018.04.004

Cited by 100 publications

(84 citation statements)

References 51 publications

(46 reference statements)

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“…Our results are similar to that of a recently published INTERMACS registry report of TAH patients, though the number of patients with amyloidosis was not specified in this report . Of 450 patients, 43% were INTERMACS Profile 1 and 37% were INTERMACS Profile 2, similar to the 45% and 36%, respectively, in our analysis.…”

Section: Discussionsupporting

confidence: 90%

“…While the sample is small, it must be viewed in the context of other amyloid MCS studies. The INTERMACS registry highlights the limited experience with mechanical support for cardiac amyloidosis: 10 606 devices reported to the registry between 2008 and 2014, 16 were LVADs implanted in patients with cardiac amyloidosis, and there is no published experience from the INTERMACS registry on the use of biventricular MCS in patients with cardiac amyloidosis …”

Section: Discussionmentioning

confidence: 99%

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Mechanical circulatory support for cardiac amyloidosis

Kittleson

Cole

Patel

et al. 2019

Clinical Transplantation

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Background Cardiac amyloidosis, typically from abnormal deposition of AL or ATTR amyloid protein, can result in heart failure requiring transplantation (HTx). The role of mechanical circulatory support (MCS) is not well‐established. The purpose of this study was to present our experience with MCS in patients with cardiac amyloidosis. Methods Consecutive patients with cardiac amyloidosis who received MCS at Cedars‐Sinai Medical Center between 2010 and 2018 were reviewed. Clinical characteristics and outcomes were compared to a control group of MCS patients without amyloid matched 2:1 for age and INTERMACS Profile. Results 11 amyloid patients underwent durable MCS, two with paracorporeal biventricular assist devices and 9 with total artificial hearts. No patients received isolated left ventricular assist device support. By 1 year, 9 (82%) of patients in the MCS‐Amyloid group had been transplanted and 2 (18%) had died. In the MCS‐No Amyloid group, by 1 year, 8 (36%) of patients had been transplanted, 10 (46%) had died, and 4 (18%) were still living with MCS. Conclusions Over a 9‐year period, patients with amyloid cardiomyopathy who required MCS at our institution all received durable biventricular MCS. For carefully selected patients, this approach is feasible with acceptable outcomes as bridge to transplantation.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Mechanical circulatory support for cardiac amyloidosis

Kittleson

Cole

Patel

et al. 2019

Clinical Transplantation

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“…Based on institutional and INTERMACS reports, rates of survival to transplantation range from mid‐50% up to 75%. Outcomes, which are dependent on clinical experience with patient selection and management and the patient’s comorbidities at the time of implantation, are similar to outcomes with the use of other devices such as left VAD (LVAD) plus a temporary right VAD (RVAD) or BiVADs, indicating that the outcomes are more related to patient than device factors.…”

Section: Building On the Pastmentioning

confidence: 99%

SynCardia total artificial heart opportunities and challenges moving forward

Arabía

2019

Artificial Organs

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“…A variety of options exist for its treatment, but heart transplantation remains the gold standard (1). The lack of donors leads to an increased use of ventricular assist devices (VAD) as a bridge to transplant (BTT) or as a destination therapy (2). Among patients with advance heart failure, those with biventricular failure have the worst prognosis and very few available options while waiting for transplantation (1).…”

Section: Introductionmentioning

confidence: 99%

SynCardia, total artificial heart, as a bridge to transplant

Hulman¹,

Artemiou²,

Hudec³

et al. 2019

BLL

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INTRODUCTION: Implantation of a total artifi cial heart is an alternative to durable biventricular assist device support in selected patients. We present our initial experience with the implantation of the SynCardia total artifi cial heart (TAH) in three patients. The fi rst patient, was the fi rst SynCardia (TAH) implantation in the Visegrad Four (V4) countries METHOD: Three patients with severe refractory end stage biventricular heart failure listed for heart transplant were indicated for SynCardia TAH implantation RESULTS: We present in details the perioperative and postoperative outcomes of these patients. The fi rst and the third patient, after 195 and 126 days of TAH support respectively, had a successful heart transplants, the second patient died on 11th postoperative day. The cause of death was brain bleeding due to ruptured undiagnosed brain aneurysm. CONCLUSION: SynCardia TAH is an alternative therapy in patients with end-stage biventricular heart failure waiting for heart transplantation. The SynCardia TAH with pulsatility resembles the physiologic circulation, improves the condition of the patients and increases survival compared to the biventricular assist devices. It is an intermediate step until the development of genetically modifi ed animal hearts, engineered bioartifi cial hearts or hearts from induced pluripotent stem cells that would replace the failing heart in the patients with end-stage heart disease (Tab. 2, Fig. 1, Ref. 27).

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Interagency registry for mechanically assisted circulatory support report on the total artificial heart

Cited by 100 publications

References 51 publications

Mechanical circulatory support for cardiac amyloidosis

Mechanical circulatory support for cardiac amyloidosis

SynCardia total artificial heart opportunities and challenges moving forward

SynCardia, total artificial heart, as a bridge to transplant

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