Past and Present of Total Artificial Heart Therapy: A Success Story

Samak, Mostafa; Fatullayev, Javid; Sabashnikov, Anton; Zeriouh, Mohamed; Rahmanian, Parwis B.; Choi, Yeong‐Hoon; Wippermann, Jens; Wahlers, Thorsten; Schmack, Bastian; Ruhparwar, Arjang; Dohmen, Pascal M.; Kretzler, Matthias; Popov, Aron‐Frederik; Simon, Andrè; Weymann, Alexander

doi:10.12659/msmbr.895418

Cited by 15 publications

(14 citation statements)

References 37 publications

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“…The idea of a TAH replacing the human heart has long been an intriguing challenge, with the first TAH implanted in a human in 1969 by Cooley et al (61). Since this first TAH implantation, a number of devices and designs have been investigated (62), but none have been as successful as the Jarvik 7, later renamed CardioWest and now SynCardia TAH (SynCardia Systems, Inc., Houston, TX, USA), which relies on an external pulsatile pneumatic pump attached to the TAH through reinforced polyurethane drivelines. In 2004, CardioWest (now SynCardia 70cc) became the first and only TAH to get FDA approval for BTT (63,64), and clinical trial began in 2014 to evaluate the device for DT in biventricular patients ineligible for heart transplantation (65).…”

Section: Rvf and Tah Developmentsmentioning

confidence: 99%

“…Currently, INTERMACs registry data for biventricular HF patients receiving MCS as BTT shows one year mortality for SynCardia TAH is 59% vs. 56% for BiVADs (9). Despite the development of the SynCardia pumps, the pumps are still underutilized and only implanted in 50-80 patients per year (Figure 3) due to a ~59% post-implant one year survival ( Figure 4) (9) but markedly decreased survival further past one year due to mechanical parts prone to malfunction, high incidence of thrombosis and hemoincompatibility (62). Other limitations include the need for a large and loud external motor, and dependency on an external energy supply.…”

Section: Rvf and Tah Developmentsmentioning

confidence: 99%

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Advancements in mechanical circulatory support for patients in acute and chronic heart failure

Csepe

Kilic

2017

J. Thorac. Dis.

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Cardiogenic shock (CS) continues to have high mortality and morbidity despite advances in pharmacological, mechanical, and reperfusion approaches to treatment. When CS is refractory to medical therapy, percutaneous mechanical circulatory support (MCS) should be considered. Acute MCS devices, ranging from intra-aortic balloon pumps (IABPs) to percutaneous temporary ventricular assist devices (VAD) to extracorporeal membrane oxygenation (ECMO), can aid, restore, or maintain appropriate tissue perfusion before the development of irreversible end-organ damage. Technology has improved patient survival to recovery from CS, but in patients whom cardiac recovery does not occur, acute MCS can be effectively utilized as a bridge to long-term MCS devices and/or heart transplantation. Heart transplantation has been limited by donor heart availability, leading to a greater role of left ventricular assist device (LVAD) support. In patients with biventricular failure that are ineligible for LVAD implantation, further advancements in the total artificial heart (TAH) may allow for improved survival compared to medical therapy alone. In this review, we discuss the current state of acute and durable MCS, ongoing advances in LVADs and TAH devices, improved methods of durable MCS implantation and patient selection, and future MCS developments in this dynamic field that may allow for optimization of HF treatment.

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Section: Rvf and Tah Developmentsmentioning

confidence: 99%

Section: Rvf and Tah Developmentsmentioning

confidence: 99%

Advancements in mechanical circulatory support for patients in acute and chronic heart failure

Csepe

Kilic

2017

J. Thorac. Dis.

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“…Implantation of LVAD alone could aid these patients because of its ability to partially right ventricular functions, and this advantage makes the LVAD approach generally preferred over TAH in patients with biventricular failure. The usage of TAH devices is restricted to the patient's in whom LVAD is not feasible due to infiltrative or restrictive CMPs, cardiac malignancies, nonsurgical postinfarction ventricular septal defect, intractable ventricular arrhythmias, and cardiac graft failure [86]. The device has two artificial ventricles lined with polyurethane, and ejects blood via a four-layer, moving diaphragm driven pneumatically or hydraulically [87].…”

Section: Total Artificial Heart (Tah)mentioning

confidence: 99%

Invasive Treatment in Advanced (Stage-D) Heart Failure

Kırali¹,

Yerlikhan²,

Hançer³

2017

Cardiomyopathies - Types and Treatments

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Heart failure is a complex, true pandemic clinical syndrome and is responsible for 5% of hospitalizations globally. Severe heart failure can manifest as two lethal clinical entities: (1) acute cardiac decompensation with cardiogenic shock after large acute myocardial infarction with mortality rates approaching 50% or after cardiac surgery with mortality rates higher than 65% and (2) chronic destructive cardiac remodeling or acute decompensative exacerbations of cardiomyopathies with one-year mortality of approximately 80% (worse than most types of cancer). Interventional therapies aim first to improve symptoms and life expectancy in patients with severe heart failure syndrome, second to prevent left ventricular remodeling, and third to bridge patients to long-term mechanical circulatory support or transplantation. Several treatment options can be used to stabilize patients. In particular, new percutaneous mitral valve interventions and short-term circulatory support devices open up a new temporary treatment area in symptomatic Stage-D heart failure. The durable or curable surgical destination treatment will be only permanent ventricular assist devices or heart transplantation. This chapter focuses on the treatment steps and new approaches in hospitalized Stage-D heart failure patients.Keywords: heart failure, heart transplantation, ventricular assist device, ECMO, ECLS At end-stage, any type of cardiomyopathy (CMP) causes a complex clinical heart failure (HF) syndrome, which results from structural and/or functional impairment of ventricular filling or ejection. This dire clinical situation can cause an adverse vicious cycle that is ultimately fatal if not treated by pharmacological or invasive mechanical support or heart transplantation (HTx). Left ventricular functional abnormalities range from normal-sized left ventricle (LV) with preserved left ventricular ejection fraction (LVEF) to severe left ventricular dilatation (LVD) with markedly reduced LVEF. Reduced LVEF is defined as the clinical diagnosis of HF and LVEF ≤40%, which means a clinic and functional association of systolic and/or diastolic LVD.© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Abnormal systolic and/or diastolic functions impair left ventricular contractile and relaxation functions that result in increasing left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV), as well as left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD), with the alteration of the left ventricular shape from conical form to spherical form. Adverse elevation of preload and afterload results in increasing left ventricular end-diastolic pressure (LVEDP) and left ventricular end-systolic pressure (LVESP). Inadequate unloading is the pr...

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“…The modern treatment of heart failure is often associated with multiple surgical procedures and devices with potential complications (1,2). Due to the fact that HTX is gradually becoming a redo procedure, even more devices and strategies are being developed to facilitate faster organ offers (3,4).…”

Section: Palacos Bone Cement Is a Suitable Treatment For Sternal Recomentioning

confidence: 99%

Palacos Bone Cement Is a Suitable Treatment for Sternal Reconstruction in Patients After Total Artificial Heart Implantation Undergoing Heart Transplantation

et al. 2016

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Past and Present of Total Artificial Heart Therapy: A Success Story

Cited by 15 publications

References 37 publications

Advancements in mechanical circulatory support for patients in acute and chronic heart failure

Advancements in mechanical circulatory support for patients in acute and chronic heart failure

Invasive Treatment in Advanced (Stage-D) Heart Failure

Palacos Bone Cement Is a Suitable Treatment for Sternal Reconstruction in Patients After Total Artificial Heart Implantation Undergoing Heart Transplantation

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