100 Total Artificial Hearts: Patient Characteristics and Clinical Outcomes at a High-Volume Transplant Center
On-Demand
Purpose: Total artificial hearts (TAH) provide a temporary mechanical circulatory support option to patients with advanced biventricular failure or refractory arrhythmias. The worldwide experience with the TAH remains limited. The purpose of this study was to review the patient characteristics and clinical outcomes following TAH implantation at a high-volume transplant center.
Methods: A retrospective review of the first 100 TAH implants at our institution was undertaken. Patient records were retrieved from a prospectively gathered database. Pre-operative patient demographics, clinical characteristics and clinical outcomes were analyzed and stratified according to their INTERMACS profile at time of implant (INTERMACS 1 vs. INTERMACS 2+). Continuous variables were compared using a two-tailed t-test or Wilcoxon rank sum test, and categorical variables were analyzed by chi-square or Fisher’s exact test, as appropriate.
Results: Between January 2012 and May 2021, a total of 100 TAH were implanted in 99 patients at our center (one patient required a second device implantation). The patient characteristics stratified by INTERMACS profile are summarized in Table 1. Continuous variables are reported as mean (standard deviation) while categorical variables are reported as count (percentage).
Figure 1 plots the cumulative probability of transplantation or death following TAH implantation, as stratified by INTERMACS profile. The longest time on device support was 849 days (mean 187 +/- 210 days) prior to transplantation. Over the study period, 61% of patients were successfully bridged to transplantation while 38% died on device support.
Conclusion: A review of the first 100 TAH implants at our institution shows findings in keeping with prior case series and reports from INTERMACS in terms of patient characteristics and clinical outcomes. Similar analyses will be crucial to ensure adequate patient selection and management as we adopt new devices and technologies.
Identify the source of the funding for this research project : This project was completed without additional funding sources.