Total artificial heart

Building a Bridge to Save a Failing Ventricle: Radiologic Evaluation of Short- and Long-term Cardiac Assist Devices

“…The complications associated with a TAH are similar to those seen with VAD implantation, with infection and bleeding being the most common (62)(63)(64). Respiratory infection, driveline infection, mediastinitis, and/or superficial sternal infection may occur.…”

“…Respiratory infection, driveline infection, mediastinitis, and/or superficial sternal infection may occur. Systemic complications such as respiratory dysfunction related to acute respiratory distress syndrome or pulmonary infection, neurologic events, and renal dysfunction are also common (63,65). Complications unique to the SynCardia TAH include those related to size mismatches, which may result in compression of the left superior pulmonary vein or IVC and a delay in chest closure, and device malfunction caused by an air leak due to a tear at the driveline-ventricle junction.…”

“…A TAH is preferred over LVAD implantation for patients with massive myocardial damage such as post-myocardial infarction ventricular septal defects and for patients with failed cardiac transplantation (63). Options for patients requiring biventricular support are limited; a TAH currently represents one, if not the best, long-term surgical treatment option for these patients.…”

Mechanical circulatory support

“…Current versions of TAH are limited by their size, durability, and complications. Continuous flow TAH pumps are being developed and evaluated in preclinical research studies; these pumps may offer hope in the future [82].…”

Perioperative Care of the Patient With the Total Artificial Heart

“…14,22 Patients being evaluated for mechanical circulatory support who appear to be at high risk of worsening right ventricular function after isolated LVAD insertion should be considered for planned biventricular support, because outcomes appear superior with primary biventricular device placement versus late conversion. [27][28][29] Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. In the past 10 years, over 75% of patients receiving a TAH were categorized as Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS ® ) profiles 1 or 2, a corresponding with critical cardiogenic shock and progressive decline on inotropes, respectively (Table 1).…”