The CardioWest Total Artificial Heart for Chronic Heart Transplant Rejection

Abstract

Mechanical circulatory support has been used to treat graft failure after heart transplantation, but in patients who needed mechanical circulatory support because of chronic rejection, we have suffered from the treatment because its outcome was catastrophic. Multiple organ failure was often caused by the addition of or increase in immunosuppressive medications, and it is known as a cause of the poor outcomes. The CardioWest total artificial heart was implanted for a case of chronic heart transplant rejection to enable complete withdrawal of immunosuppressive medication. The patient underwent re-heart transplantation, with a good result. This is a new therapeutic technique for chronic graft rejection. (Circ J 2009; 73: 1167 -1168

Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review

“…Early implantation prior to significant end‐organ damage may improve results. Although mortality remains high, it appears to be at least equivalent to or better compared to patients bridged to retransplantation utilizing other forms of VAD support .…”

“…There have been only a few publications on the use of TAH‐t as a bridge to redo heart transplantation comprising individual case reports and patients included in larger series of TAH‐t results . The first TAH‐t implantation for acute rejection was performed in 1986.…”

“…The CardioWest total artificial heart (TAH‐t; SynCardia Systems, Inc., Tucson, AZ, USA) biventricular mechanical circulatory support device is an option for bridge to transplantation, which allows for removal of the transplanted graft and discontinuation of all immunosuppression. However, there are limited publications on the success of this device as a bridge to retransplantation in supporting heart transplant patients with severe graft dysfunction secondary to rejection . We present our experience and review of worldwide experience for use of TAH‐t in this type patient.…”

Mechanical Circulatory Assistance - An Evolving Therapy -

“…The total artificial heart (SynCardia Systems, Inc, Tuscon, AZ, USA) is an emerging option for such patients, although there are only 31 centers worldwide currently approved for implantation of this device (see Figure 6). 35 …”

Total artificial heart for patients with allograft failure

“…The introduction of catheter-based valve implantation has produced a new option of a valve-in-valve approach to failing bioprostheses. 2 Without the anatomic difficulties associated with transcutaneous valve implantation in a native mitral annulus or a preexisting mitral annuloplasty ring, performance of the MVinV procedure is relatively straightforward because of the circular bioprosthesis sewing ring, which serves as an excellent landing zone for the transcutaneous valve stent.Cheung and colleagues 3 reported a small series of 11 patients (mean Society of Thoracic Surgeons score of 16%) with symptomatic mitral prosthetic valve dysfunction who underwent transapical MVinV. The success rate was 100%, with no 30-day mortality.…”