Left Ventricular, Biventricular and Total Artificial Heart Support are Associated with Similar Levels of Allosensitization in Bridge-to-Transplant Patients: An Analysis of the UNOS Database

2016 ◽  
Vol 35 (4) ◽  
pp. S128
Author(s):  
M. Yuzefpolskaya ◽  
P.N. Trinh ◽  
A.R. Garan ◽  
K. Takeda ◽  
H. Takayama ◽  
...  
2016 ◽  
Vol 19 (1) ◽  
pp. 014
Author(s):  
Amit Prasad ◽  
Kai Singbartl ◽  
Jacqueline Boone ◽  
Behzad Soleimani ◽  
Mohamad Zeriouh ◽  
...  

As a bridge to transplant, the Syncardia™ total artificial heart (TAH) is an option for patients who are not candidates for left ventricular assist devices (LVAD) due to right ventricular failure. The need for nutritional support in these patients is essential for a favorable outcome. Low body mass indexes and albumin levels have been associated with increased morbidity and mortality in cardiac surgery patients [Alverdy 2003]. It is not uncommon for postoperative patients to have difficulty in consuming enough calories after surgery, which is further complicated by a hypermetabolic demand due to surgical stress. Enteral nutrition has typically been favored for gut mucosal integrity and bacterial flora [Alverdy 2003] [Engleman 1999]. We describe the need for prolonged enteral nutritional support in a TAH patient that was accomplished with a percutaneous endoscopic gastrostomy (PEG) tube.


2016 ◽  
Vol 19 (1) ◽  
pp. 012 ◽  
Author(s):  
Amit Prasad ◽  
Ali Ghodsizad ◽  
Walter Pae ◽  
Kai Singbartl ◽  
Jacqueline Boone ◽  
...  

<p>The Syncardia™ total artificial heart (TAH) is an option for patients as a bridge to transplant in those who are not candidates for left ventricular assist devices (LVAD) due to right ventricular failure. Postoperative course is highly dependent on volume status and aggressive diuresis is often necessary. One complication from aggressive diuresis is hypokalemia; however, in these patients we tolerate a lower potassium level because cardiac arrhythmias are not a concern.  However, in two separate instances non-cardiac symptoms related to severe hypokalemia occurred. These symptoms included nystagmus in one patient and agitation, tremors, and having an “out-of-body” experience in the other patient. Both these patients had resolution of symptoms with potassium replacement.</p>


2021 ◽  

The HeartMate 3 is a ventricular assist device that supports the heart with a centrifugal continuous flow. It contains a fully levitated rotor to minimize hemolysis and was initially designed as an apical intrapericardial implant. It can be used as a bridge to a transplant, to recovery, or to destination therapy. After we excise the ventricles, we implant 2 HeartMate 3 devices as a total artificial heart (HeartMate 6). The patient was 35 years old when the devices were implanted and had been diagnosed with Yamaguchi syndrome (apical hypertrophic cardiomyopathy) at 13 years of age. Being listed for a transplant was not an option due to secondary pulmonary hypertension. Furthermore, the conventional method of apically implanting a left ventricular assist device was not possible due to the underlying pathology. A HeartMate 6 implant as a bridge to transplant therapy was planned. Additionally, a CardioMEMS HF System was implanted to monitor the pulmonary artery pressure. The video tutorial provides step-by-step instructions for implanting 2 HeartMate 3 devices as a total artificial heart.


2021 ◽  
Vol 40 (4) ◽  
pp. S528
Author(s):  
G.T. Gibson ◽  
S. Rangasamy ◽  
J. Contreras ◽  
A. Singhvi ◽  
A. Fox ◽  
...  

2012 ◽  
Vol 31 (4) ◽  
pp. S109-S110
Author(s):  
A. Nguyen ◽  
M. Pozzi ◽  
C. Mastroianni ◽  
P. Leprince ◽  
P. Alain ◽  
...  

1991 ◽  
Vol 2 (3) ◽  
pp. 587-597
Author(s):  
Lawrence E. Barker

In the early 1800s, an awareness of potential ventricular failure stimulated interest in artificial heart replacement. In 1937 the first total artificial heart (TAH) was implanted into the chest of a dog by Russian physicians. The primary driving force for mechanical cardiac assistance developed from the necessity for circulatory assistance in order to perform corrective cardiac surgery. In 1953 the first successful closure of an atrial septal defect using extracorporeal circulation was performed. During the following decade the concept of using mechanical devices to assist the failing heart was aggressively pursued. This culminated in the first implant of a TAH in a human in 1969 as a bridge to transplant. Clinical implant of the TAH as a permanent device was performed in 1982 by researchers at the University of Utah. This patient lived for 112 days. Three successive permanent implants were performed in Louisville, Kentucky, with one patient surviving for 620 days. All of these permanent TAH patients suffered from device-related complications including bleeding, infection, and thromboembolic events. It became apparent that the present configuration of the TAH with its external drive lines and large air console was not ideal for long-term support. In 1985 the first implant of the Symbion J-7-100 TAH (Jarvik-7) as a bridge to transplant was performed. This patient was supported by the device for 9 days and was successfully transplanted and discharged home. Since 1985 more than 170 patients have been bridged using the Symbion J-7 TAH with more than 70% of these patients being successfully transplanted. The incidence of thromboembolic events has dramatically reduced with better understanding of anticoagulation requirements. Infection continues to be the greatest potential complication with these patients. In spite of this, the pneumatic TAH has proved to be an adequate bridge to transplant device


1998 ◽  
pp. 421-423
Author(s):  
Ricardo J. Moreno-Cabral ◽  
Robert M. Adamson ◽  
Walter P. Dembitsky ◽  
Pat O. Daily ◽  
Francisco A. Arabía ◽  
...  

2017 ◽  
Vol 39 (20) ◽  
pp. 1794-1798 ◽  
Author(s):  
Mattia Arrigo ◽  
Nicolas Vodovar ◽  
Hélène Nougué ◽  
Malha Sadoune ◽  
Chris J Pemberton ◽  
...  

Abstract Aims Heart failure (HF) is accompanied by major neuroendocrine changes including the activation of the natriuretic peptide (NP) pathway. Using the unique model of patients undergoing implantation of the CARMAT total artificial heart and investigating regional differences in soluble neprilysin (sNEP) in patients with reduced or preserved systolic function, we studied the regulation of the NP pathway in HF. Methods and results Venous blood samples from two patients undergoing replacement of the failing ventricles with a total artificial heart were collected before implantation and weekly thereafter until post-operative week 6. The ventricular removal was associated with an immediate drop in circulating NPs, a nearly total disappearance of circulating glycosylated proBNP and furin activity and a marked decrease in sNEP. From post-operative week 1 onwards, NP concentrations remained overall unchanged. In contrast, partial recoveries in glycosylated proBNP, furin activity, and sNEP were observed. Furthermore, while in patients with preserved systolic function (n = 6), sNEP concentrations in the coronary sinus and systemic vessels were similar (all P > 0.05), in patients with reduced left-ventricular systolic function, sNEP concentration, and activity were ∼three-fold higher in coronary sinus compared to systemic vessels (n = 21, all P < 0.0001), while the trans-pulmonary gradient was neutral (n = 5, P = 1.0). Conclusion The heart plays a pivotal role as a regulator of the endocrine response in systolic dysfunction, not only by directly releasing NPs but also by contributing to circulating sNEP, which in turn determines the bioavailability of other numerous vasoactive peptides.


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