The aim of this review is to describe the current use, indications, and outcomes of the Syncardia temporary total artificial heart (TAH) (Syncardia Systems, Tucson, AZ, USA), the only TAH currently approved as a bridge-to-transplant strategy in Canada, the United States, and Europe. With more than 1700 implantations worldwide, the Syncardia temporary TAH is the most commonly used pump. Globally, it represents 2% of the long-term mechanical circulatory support devices implanted, with a recent decrease in its use. The main candidates for TAH are heart transplant candidates suffering from acute or decompensated chronic irreversible biventricular failure at high risk of imminent death and for whom a suitable donor is not available. Most patients receiving a TAH are acutely ill, characterized by an INTERMACS profile of 1 or 2, and 20% are under extracorporeal membrane oxygenation. The TAH provides efficient circulatory support and allows the end-organ to History of Cardiac Replacement Therapy Over the past 50 years, 2 distinct options have been explored for cardiac replacement therapy. The first successful attempt was performed by Shumway and Lower, who developed a technique in animals known as orthotopic HT.

patients (80.9%) with a mean age of 53 years were mainly treated with the Medtronic HVAD device (76%). Baseline characteristics including the severity of LV and RV dysfunction (LVEF 19%, TAPSE 16mm Controlgroup) were comparable between both study-groups. There was no difference regarding preoperative LV dilatation (LVEDD 78mm MR-group vs. LVEDD 75mm Control-group; p=0.67). We found significantly increased parameters of mitral leaflet-tethering prior to LVAD implantation within the MR-group (Tenting-height: 11.5mm vs. 7.5mm; p=0.03; Tenting-area: 244mm 2 vs. 178mm 2 ; p=0.04). Tethering of the anterior mitral leaflet (AML) was particularly increased in the MR-group (p=0.02). 12 months after LVAD implantation patients within the MR-group showed a significantly reduced exercise capacity (6-minute walk test: 293m vs. 439m; p=0.04). Overall survival was significantly impaired in the MR-group in comparison to the Control-group (40% vs. 91%; p=0.002). Conclusion: LVAD recipients with persistent MR despite mechanical unloading showed significant echocardiographic signs of mitral leaflet tethering prior to LVAD implantation. Furthermore, persistent MR 12 months after LVAD implantation was associated with a reduced exercise capacity and an impaired overall survival. If correction of preoperative MR improves post implant survival needs to be shown in future studies.

Background/Purpose Application-based technology has been studied for patient engagement and collecting patient-reported outcomes (PROs) in several one-day surgical specialties with limited research in transcathether valve therapies program. The aim of study was to determine the effectiveness of app-based technology for collecting PROs, improving the patient experience, and reducing health services utilization in a transcatheter valve implantation (TAVI) program. Methods Patients accessed an interactive app via smartphones. Patients were guided from their visit to the TAVI clinic via reminders, tasks, PRO surveys, and evidence-based education. They received notifications and health surveys 2 days before the procedure to ensure they were ready for the procedure. In the postoperative period, patients were engaged with daily health surveys to track warning signs and recovery milestones for 7 days. Based on the patient's signs and symptoms, the app escalated lower risk issues to self-care education or higher risk issues to the care team (TAVI program's nurse coordinator). Follow-up surveys and Kansas City Cardiomyopathy Questionnaire (KCCQ12) were sent to patients at 1, 3, 6 and 12 months to evaluate their functional recovery. All data are reported with median and interquartile range. Results 227 patients underwent a TAVI procedure at the MHI from December 2020 to October 2021. 99 patients (44%) accepted to use the application and formed the digital application group. The two groups (digital application group vs. non-digital application group) were comparable in terms of age (76 years old (72, 81) vs 77 years old (71,82)), STS (Society of Thoracic Surgeons' risk model) score (6,1% vs 6,7%), vascular complications (8,1 vs 7.8%) and post procedure pacemakers (10,1% vs 10.9%). In the digital application group, 93% recommended the application, 95% said it helped them feel more confident before the procedure and 84%, after the procedure. KCCQ12 score (PRO) improved from 34/70 (28, 41) at baseline to 54/70 (48,62) at 1 month after the procedure and remained stable over the 12 months. Digital application use helped to reduce emergency visits by 33.5% (7.9 vs 11.9%) and rehospitalizations related to the procedure by 50.1% (7.9% vs 15.9%) in the month following the TAVI procedure. Conclusion App-based technology for patient engagement is an effective modality to enhance the patient experience, better understand the trajectory of recovery, gather PRO and reduce unnecessary health services utilization in aging population of a TAVI program. Funding Acknowledgement Type of funding sources: None.

No abstract