Total artificial heart bridge to transplantation: a 9-year experience with 62 patients

Copeland, Jack G.; Smith, Richard G.; Arabía, Francisco A.; Nolan, Paul E.; McClellan, Douglas; Tsau, Pei H.; Sethi, Gulshan K.; Bose, Raj; Banchy, M E; Covington, D.; Slepian, Marvin J.

doi:10.1016/j.healun.2003.07.024

Cited by 85 publications

(49 citation statements)

References 10 publications

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“…Given the overall acuity of illness at the time of TAH implantation, it is not surprising that those with pre-existing significant renal failure are likely to develop further renal insufficiency and others with preserved renal function may develop new-onset renal failure. Postoperative renal failure requiring dialysis with TAH implantation in patients with no significant preoperative renal failure was noted in 15-38% of patients, 10,18,20 whereas we observed this in 30% of our patients. To allow adequate time for stabilization of overall circulation with TAH support and, in particular, for renal function recovery, we elected to monitor renal recovery beginning at 30 days after TAH implantation.…”

Section: Discussioncontrasting

confidence: 57%

“…Overall mortality at 6 months of follow-up was 30%, similar to the reported mortality of 21-52% with TAH implantation. 9,10,20 Although renal failure was the most common morbidity and component of multisystem organ failure after TAH implantation in the reported literature, 9,18,20 in our study cohort mortality among patients with preoperative dialysis dependency was 16% (one of the six patients); however, three of the six patients (50%) who developed a need for newonset dialysis died of multisystem organ failure.…”

Section: Discussionmentioning

confidence: 63%

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Renal Function Recovery with Total Artificial Heart Support

Quader

Goodreau²,

Shah³

et al. 2016

ASAIO Journal

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Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 63%

Renal Function Recovery with Total Artificial Heart Support

Quader

Goodreau²,

Shah³

et al. 2016

ASAIO Journal

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“…Therefore, TEG monitoring is valuable for intraoperative coagulation monitoring, and it has been successfully used to detect hypercoagulability [1,2]. In 2004, Copeland et al described TEG findings in the setting of hypercoagulation during procedures involving total artificial heart placement [21]. In addition, as mentioned above, an association between hypercoagulation by TEG and postoperative thrombotic complications was shown by McCrath et al [14], thereby validating the importance of TEG as a useful adjunct in the intraoperative monitoring of hypercoagulation.…”

Section: Discussionmentioning

confidence: 97%

Reversal of hypercoagulability with hydroxyethyl starch during transplantation: a case series

Fukazawa

Pretto

2011

Journal of Clinical Anesthesia

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“…While manufacturers provide general guidance regarding patient size, the trend in both adult and pediatric centers is to implant devices in smaller [41, 46, 47 • ]. This trend is not without risk as there are reports of complications due to patient-device mismatch [61]. In response, some centers have begun utilizing three-dimensional (3D), virtual device implantation to better define the limits of patient eligibility [35, 39 • ].…”

Section: Optimizing ''Device Fit''mentioning

confidence: 99%

Children Are Not Small Adults: Options for Pediatric Ventricular Assist Devices

2015

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The number of children supported with ventricular assist devices (VADs) has grown rapidly over the last few years. VAD use in children holds the promise of improving the outcomes in pediatric end-stage heart failure; however, the risk-benefit profile inherent to VAD use is not uniform across all ages, sizes, and diagnoses. Device use in children has underscored a number of issues that distinguish pediatric and adult heart failure such as the high prevalence of complex congenital heart disease and the challenges inherent to supporting infants and small children. The use of VADs in children also raises a range of social, emotional, and logistic changes unique to children across the age spectrum.

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Total artificial heart bridge to transplantation: a 9-year experience with 62 patients

Cited by 85 publications

References 10 publications

Renal Function Recovery with Total Artificial Heart Support

Renal Function Recovery with Total Artificial Heart Support

Reversal of hypercoagulability with hydroxyethyl starch during transplantation: a case series

Children Are Not Small Adults: Options for Pediatric Ventricular Assist Devices

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