Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart

Shah, Keyur B.; Thanavaro, Kristin L.; Tang, Daniel; Quader, Mohammed; Mankad, Anit K.; Tchoukina, Inna; Thacker, Leroy R.; Smallfield, Melissa C.; Katlaps, Gundars; Heß, Michael; Cooke, Richard H.; Kasirajan, Vigneshwar

doi:10.1016/j.cardfail.2016.04.016

Cited by 23 publications

(9 citation statements)

References 14 publications

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“…As discussed above, this may be due to a lack of statistical power or by the dynamic nature of heart failure, which could render the INTERMACS profile more relevant to outcomes closer to the time at which it is measured. The latter notion aligns with the results of Shah et al (2016), who illustrated that INTERMACS profile at the time of TAH implantation is prognostic of short‐term outcomes following TAH implantation but not longer‐term outcomes of patients who subsequently receive a HTx . Similarly, Barge‐Cabalerro et al (2013) found that preoperative INTERMACS profile was associated with short‐term post‐operative survival but not with the long‐term survival among those patients who were discharged from hospital alive .…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have demonstrated that heart failure patients profiled as INTERMACS I or II have worse outcomes following VAD implantation, TAH implantation, or HTx . Importantly, these studies assessed INTERMACS profile at the time of the advanced HF therapy intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated that heart failure patients profiled as INTERMACS I or II have worse outcomes following VAD implantation, 5-7 TAH implantation, 8 IV-V. 16 This led the authors to conclude that INTERMACS profile may be useful in decision-making about advanced HF therapies. 16 Our results extend the conclusions from this study by includ- There was an observable association between INTERMACS profile at the time of assessment and overall mortality or delisting, but statistical significance was not reached.…”

Section: Relation To Previous Workmentioning

confidence: 99%

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Utility of the INTERMACS profile at the time of assessment for heart transplant

Friesen

Foroutan

Krakovsky

et al. 2020

Clinical Transplantation

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The Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) profiles are associated with mortality in heart failure patients undergoing ventricular assist device (VAD) implantation and heart transplantation (HTx). We assessed the prognostic value of the INTERMACS profile at the time of assessment for HTx or durable VAD implantation as bridge to candidacy (BTC). A total of 503 consecutive patients considered for HTx or VAD between 2006 and 2016 were included. The associations between INTERMACS profile and (a) waitlist mortality or delisting, (b) probability of HTx, and (c) overall mortality or delisting were evaluated using multivariable analysis. Median follow‐up time was 2.9 years (IQR: 0.9‐5.5) during which 184 received VAD, 347 received HTx, and 73 died (27 waitlist, 46 post‐transplant). INTERMACS I‐II profile was associated with higher waitlist mortality or delisting (HR: 3.83, 95% CI: 1.22‐12.03), and this risk was reversed by VAD implantation (HR: 0.12, 95% CI: 0.03‐0.50). INTERMACS III‐IV profile was associated with a higher probability of HTx (HR: 1.82, 95% CI: 1.37‐2.40). INTERMACS profile was not associated with the composite outcome of overall mortality or delisting. These results emphasize the prognostic utility of INTERMACS at time of decision for advanced therapies and its potential value in selecting patients for different interventions.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Relation To Previous Workmentioning

confidence: 99%

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Utility of the INTERMACS profile at the time of assessment for heart transplant

Friesen

Foroutan

Krakovsky

et al. 2020

Clinical Transplantation

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“…Although the overall 6-month survival for the TAH-t cohort is lower than that of patients who received an isolated LVAD, these patient sub-sets are not comparable in that the TAH-t was selected because LVAD support was deemed inappropriate secondary to biventricular failure. 36,37 Initial consideration was given to comparing the TAH-t cohort to patients in INTERMACS who had received BiVAD support, but this proved to be a challenge. Patients who have received BiVAD in the INTERMACS database were implanted with permutations of different LVADs and RVADs.…”

Section: Discussionmentioning

confidence: 99%

Interagency registry for mechanically assisted circulatory support report on the total artificial heart

Arabía

Cantor

Koehl

et al. 2018

The Journal of Heart and Lung Transplantation

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104

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“…Our results showed that this device provided acceptable survival rates to transplantation. Clinical investigations showed that the INTERMACS profi le had an impact on survival, where INTERMACS profi le 1 had reduced survival to transplantation rates compared with the less sick profi les (9).…”

Section: Discussionmentioning

confidence: 99%

SynCardia, total artificial heart, as a bridge to transplant

Hulman¹,

Artemiou²,

Hudec³

et al. 2019

BLL

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INTRODUCTION: Implantation of a total artifi cial heart is an alternative to durable biventricular assist device support in selected patients. We present our initial experience with the implantation of the SynCardia total artifi cial heart (TAH) in three patients. The fi rst patient, was the fi rst SynCardia (TAH) implantation in the Visegrad Four (V4) countries METHOD: Three patients with severe refractory end stage biventricular heart failure listed for heart transplant were indicated for SynCardia TAH implantation RESULTS: We present in details the perioperative and postoperative outcomes of these patients. The fi rst and the third patient, after 195 and 126 days of TAH support respectively, had a successful heart transplants, the second patient died on 11th postoperative day. The cause of death was brain bleeding due to ruptured undiagnosed brain aneurysm. CONCLUSION: SynCardia TAH is an alternative therapy in patients with end-stage biventricular heart failure waiting for heart transplantation. The SynCardia TAH with pulsatility resembles the physiologic circulation, improves the condition of the patients and increases survival compared to the biventricular assist devices. It is an intermediate step until the development of genetically modifi ed animal hearts, engineered bioartifi cial hearts or hearts from induced pluripotent stem cells that would replace the failing heart in the patients with end-stage heart disease (Tab. 2, Fig. 1, Ref. 27).

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Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart

Cited by 23 publications

References 14 publications

Utility of the INTERMACS profile at the time of assessment for heart transplant

Utility of the INTERMACS profile at the time of assessment for heart transplant

Interagency registry for mechanically assisted circulatory support report on the total artificial heart

SynCardia, total artificial heart, as a bridge to transplant

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