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Initial United Kingdom experience with the syncardia total artificial heart
S104
34TH EACTA ANNUAL CONGRESS ABSTRACTS / Journal of Cardiothoracic and Vascular Anesthesia 33 (2019) S85 S104
heparin for cardiac surgery in HIT patients, unless its efficacy has been confirmed in a functional test prior to surgery. REFERENCE: 1-Seider S and al, J Cardiothorac Vasc Anesth, 2018 2- Gernhofer, Y.K., J Cardiothorac Surg, 2018
Session: LVAD & TRANSPLANT
September 6, 2019
S30:02 Initial United Kingdom experience with the syncardia total artificial heart ,
K. Lenartova1,3 , A. Gkikas1, S. Moravcova1, N. Marczin1, A. Simon2, C. Walker1 1
Harefield Hospital, Department of Anaesthesia and Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 2 Harefield Hospital, Department of Cardiothoracic Transplantation, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 3 Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic Introduction: The SynCardia Total Artificial Heart (TAH) is a form of mechanical circulatory support where the patient’s native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart (1). Implantation is indicated in patients with irreversible biventricular cardiac failure (2). We have recently initiated a TAH program at Harefield Hospital for the UK patient population. The aim of this study is to review our initial experience in terms of success rate of bridging patients to transplantation and post cardiac transplant outcomes.
Methods: We analysed data from all patients who received a TAH from July 2014 until April 2019 at our institution to quantify the rate of successful bridging to transplantation and the subsequent post cardiac transplant outcomes. Results: 22 patients (males, n = 14; mean age 39 § 17) received TAH implants due to severe, irrecoverable biventricular failure. Aetiologies were dilated (n = 11, 50%), ischaemic (n = 6, 27%) and valvular (n = 3, 13%) cardiomyopathies. 12 patients (55%) were on veno-arterial extra corporeal membrane oxygen support with mean duration of 8.3 § 8.6 days prior to TAH implantation. Mean duration on TAH support was 95 § 114 days. 7 patients (32%) suffered stroke, 8 (36%) required surgical exploration for bleeding and 7 (32%) developed sepsis. 9 patients (40%) were successfully bridged to and received a heart transplant, another 3 patients are on the waiting list. 6 patients (27%) are still living: 3 post heart transplantation and 3 remain on the waiting list for a heart transplant. Discussion: We have successfully introduced The TAH program in the UK as an important and unique intervention for a high risk patient population with biventricular heart failure who are not candidates for left ventricular assist device. Despite high rate of perioperative and early mortality and postoperative complications TAH implantation provides a realistic alternative for these otherwise futile cases. REFERENCES: 1. Ensminger S., Morshuis M., Gummert J., A novel bioprosthetic total artificial heart, Transplantation: (2016) 100: 4; 699 700 2. www.syncardia.com https://syncardia.com/ clinicians/clinical-resources/patients-outcomes-experience/3. NHS annual report on MCS, 2016/2017. 4. https://Www.england. nhs.uk/wp-content/uploads/.../Annual-Report-Full_201617.pdf
34TH EACTA ANNUAL CONGRESS ABSTRACTS / Journal of Cardiothoracic and Vascular Anesthesia 33 (2019) S85 S104
heparin for cardiac surgery in HIT patients, unless its efficacy has been confirmed in a functional test prior to surgery. REFERENCE: 1-Seider S and al, J Cardiothorac Vasc Anesth, 2018 2- Gernhofer, Y.K., J Cardiothorac Surg, 2018
Session: LVAD & TRANSPLANT
September 6, 2019
S30:02 Initial United Kingdom experience with the syncardia total artificial heart ,
K. Lenartova1,3 , A. Gkikas1, S. Moravcova1, N. Marczin1, A. Simon2, C. Walker1 1
Harefield Hospital, Department of Anaesthesia and Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 2 Harefield Hospital, Department of Cardiothoracic Transplantation, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 3 Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic Introduction: The SynCardia Total Artificial Heart (TAH) is a form of mechanical circulatory support where the patient’s native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart (1). Implantation is indicated in patients with irreversible biventricular cardiac failure (2). We have recently initiated a TAH program at Harefield Hospital for the UK patient population. The aim of this study is to review our initial experience in terms of success rate of bridging patients to transplantation and post cardiac transplant outcomes.
Methods: We analysed data from all patients who received a TAH from July 2014 until April 2019 at our institution to quantify the rate of successful bridging to transplantation and the subsequent post cardiac transplant outcomes. Results: 22 patients (males, n = 14; mean age 39 § 17) received TAH implants due to severe, irrecoverable biventricular failure. Aetiologies were dilated (n = 11, 50%), ischaemic (n = 6, 27%) and valvular (n = 3, 13%) cardiomyopathies. 12 patients (55%) were on veno-arterial extra corporeal membrane oxygen support with mean duration of 8.3 § 8.6 days prior to TAH implantation. Mean duration on TAH support was 95 § 114 days. 7 patients (32%) suffered stroke, 8 (36%) required surgical exploration for bleeding and 7 (32%) developed sepsis. 9 patients (40%) were successfully bridged to and received a heart transplant, another 3 patients are on the waiting list. 6 patients (27%) are still living: 3 post heart transplantation and 3 remain on the waiting list for a heart transplant. Discussion: We have successfully introduced The TAH program in the UK as an important and unique intervention for a high risk patient population with biventricular heart failure who are not candidates for left ventricular assist device. Despite high rate of perioperative and early mortality and postoperative complications TAH implantation provides a realistic alternative for these otherwise futile cases. REFERENCES: 1. Ensminger S., Morshuis M., Gummert J., A novel bioprosthetic total artificial heart, Transplantation: (2016) 100: 4; 699 700 2. www.syncardia.com https://syncardia.com/ clinicians/clinical-resources/patients-outcomes-experience/3. NHS annual report on MCS, 2016/2017. 4. https://Www.england. nhs.uk/wp-content/uploads/.../Annual-Report-Full_201617.pdf