Experience with the symbion total artificial heart as a bridge to transplantation.
From December 1985 through January 1991, 9 patients underwent bridging to transplantation using a Symbion J-7-70 total artificial heart. There were 4 female and 5 male patients aged 31 +/- 14 years (range, 15 to 52 years). Five patients were supported on an intraaortic balloon pump before total artificial heart support, and 2 had biventricular assist devices as well. Total artificial heart support was maintained for 17 +/- 12 days (range, 4 to 44 days); all patients underwent transplantation. Three patients died after transplantation on day 0 (primary donor organ failure), 25 (acute rejection), and 256 (multiorgan failure). The remainder were discharged at 41 +/- 32 days (range, 13 to 101 days). One patient died 28 months after transplantation of late acute rejection. Actuarial 1-year and 3-year survival is 67% and 55%. There were no surgical wound infections. Problems encountered in the J-7-70 period and the period after transplantation were for the most part related to patient condition in the period before implantation. The Symbion J-7-70 total artificial heart is an effective device for total circulatory support in patients with end-stage cardiogenic shock when an organ donor is not available. Organ system failure and infection before implantation may persist into the transplantation period resulting in long-term complications, increased mortality, and prolonged hospital stay; therefore, early implantation of the device when indicated should be applied.
Emery
R W
RW
Division of Mechanical Circulatory Support, Minneapolis Heart Institute, Minnesota.
Joyce
L D
LD
Prieto
M
M
Johnson
K
K
Goldenberg
I F
IF
Pritzker
M R
MR
D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000601:surgery; D002423:Cause of Death; D003327:Coronary Disease / Q000601:surgery; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000401:mortality; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016019:Survival Analysis; D014777:Virus Diseases / Q000601:surgery