Successful Bridge to Transplant in a Pediatric Patient Using the SynCardia 50 cc Total Artificial Heart

Beasley, Gary S.; Allen, Kiona Y.; Pahl, E.; Jackson, Lindsay; Eltayeb, Osama; Mongé, Michael C.; Backer, Carl L.; Thrush, Philip T.

doi:10.1097/mat.0000000000000968

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…25 The recent FDA approval of the 50 cc TAH provides an additional support option in pediatrics. 26 In summary, RHF after LVAD implantation remains a significant complication that limits the long-term mechanical circulatory support outcomes for end-stage heart failure in children. With increasing collaboration and sharing in the field of pediatric VADs through efforts such as ACTION and Pedimacs, we hope to improve understanding, risk, prevention, evaluation, and optimal medical and device management of right heart failure.…”

Section: Mechanic Al Circul Atory Supp Ort For Rhfmentioning

confidence: 99%

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Right heart failure considerations in pediatric ventricular assist devices

Law

Morales

et al. 2021

Pediatric Transplantation

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Right heart failure (RHF) is a vexing problem in children after left ventricular assist device (LVAD) implantation that can negatively impact transplant candidacy and survival. Anticipation, prevention, early identification and appropriate medical and device management of RHF are important to successful LVAD outcomes. However, there is limited pediatric evidence to guide practice. This pediatric-focused review summarizes the relevant literature and describes the harmonized approach to RHF from the Advanced Cardiac Therapies Improving Outcomes Network (ACTION). This review seeks to improve RHF outcomes through the sharing of best practices and experience across the pediatric VAD community.

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Section: Mechanic Al Circul Atory Supp Ort For Rhfmentioning

confidence: 99%

“…In carefully selected candidates, the Syncardia TM total artificial heart (TAH) is a sound option for biventricular failure 25 . The recent FDA approval of the 50 cc TAH provides an additional support option in pediatrics 26 …”

Section: Mechanical Circulatory Support For Rhfmentioning

confidence: 99%

Right heart failure considerations in pediatric ventricular assist devices

Law

Morales

et al. 2021

Pediatric Transplantation

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“…A probable explanation is the presence of anatomical and physiological challenges such as shunt-dependent circulations and/or single ventricle circulations, causing technical issues with a pump design that focuses only on biventricular circulation patients. Therefore, advanced-stage pediatric HF patients, especially CHD patients, might have benefited from replacement therapy, such as the total artificial heart (TAH) ( 9 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

“…Among viable clinical alternatives currently available, the only option as a pediatric TAH is the SynCardia 50 cc (SynCardia, Tucson, AZ). Although some space in the thoracic can be made after ventricular resection, the recommended patient size for this pump requires a body surface area (BSA) of 1.2–1.7 m 2 ( 9 , 10 , 13 ), leaving a large number of pediatric patients ineligible due to their body size.…”

Section: Introductionmentioning

confidence: 99%

Human fitting of pediatric and infant continuous-flow total artificial heart: visual and virtual assessment

Miyagi

Ahmad

Karimov

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThis study aimed to determine the fit of two small-sized (pediatric and infant) continuous-flow total artificial heart pumps (CFTAHs) in congenital heart surgery patients.MethodsThis study was approved by Cleveland Clinic Institutional Review Board. Pediatric cardiac surgery patients (n = 40) were evaluated for anatomical and virtual device fitting (3D-printed models of pediatric [P-CFTAH] and infant [I-CFTAH] models). The virtual sub-study consisted of analysis of preoperative thoracic radiographs and computed tomography (n = 3; 4.2, 5.3, and 10.2 kg) imaging data.ResultsP-CFTAH pump fit in 21 out of 40 patients (fit group, 52.5%) but did not fit in 19 patients (non-fit group, 47.5%). I-CFTAH pump fit all of the 33 patients evaluated. There were critical differences due to dimensional variation (p < 0.0001) for the P-CFTAH, such as body weight (BW), height (Ht), and body surface area (BSA). The cutoff values were: BW: 5.71 kg, Ht: 59.0 cm, BSA: 0.31 m2. These cutoff values were additionally confirmed to be optimal by CT imaging.ConclusionsThis study demonstrated the range of proper fit for the P-CFTAH and I-CFTAH in congenital heart disease patients. These data suggest the feasibility of both devices for fit in the small-patient population.

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“…While the majority of these patients have been supported with a VAD, recent advances in 3D virtual implantation and the development of the smaller, 50 cc SynCardia TAH-t (SynCardia Systems, LLC, Tucson, Ariz) have expanded the use of the TAH in children and small adults (2,3). In recent years, novel implantation methods have allowed the implantation of the device in patients with Fontan circulation and children as young as 10 years of age and as small as 0.9 m 2 body surface area (BSA) (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

The total artificial heart in pediatrics: outcomes in an evolving field

Villa¹,

Moore²,

Morales³

et al. 2020

Ann Cardiothorac Surg

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Background: The use of the SynCardia temporary total artificial heart (TAH-t) in adults has increased with time. The development of the smaller, 50 cc TAH-t has expanded the potential applications of the device in children. We sought to describe the evolving use of the TAH-t over time and describe outcomes in the current era. Methods: The SynCardia database was queried to identify all pediatric patients ≤18 years of age implanted with the device between December 1985 and October 2019. Patient demographics, clinical outcome and support characteristics collected. Results: Fifty-one children were supported, 36 with the 70 cc TAH-t and 15 with the 50 cc TAH-t with a total support time of 6,243 days. The number of implants has increased with time (19 between 2015 and 2019). A total of 13 patients have been converted to Freedom Driver support, seven 50 cc TAH-t and six 70 cc TAH-t. The majority of implants in the last 5 years (15/19, 79%) have been with the 50 cc TAH-t. The most common diagnosis was dilated cardiomyopathy [24 (47%)] and the average age at the time of implant was 16±2 years old. Overall survival for the patient cohort was 71%. Conclusions: The use of the SynCardia TAH-t to support children with end-stage heart failure has increased over time. Clinical outcomes with both the 50 cc and 70 cc TAH-t are similar to reported outcomes in adults who require TAH-t or other methods of biventricular support.

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Successful Bridge to Transplant in a Pediatric Patient Using the SynCardia 50 cc Total Artificial Heart

Cited by 8 publications

References 10 publications

Right heart failure considerations in pediatric ventricular assist devices

Right heart failure considerations in pediatric ventricular assist devices

Human fitting of pediatric and infant continuous-flow total artificial heart: visual and virtual assessment

The total artificial heart in pediatrics: outcomes in an evolving field

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