Patients with a body surface area less than 1.7 m2 have a good outcome with the CardioWest Total Artificial Heart.
BACKGROUND
A body surface area (BSA) of 1.7 m2 was considered as the lower limit to implant a CardioWest Total Artificial Heart (TAH). We reviewed our experience with the TAH in patients with a BSA of less than 1.7 m2.


METHODS
From April 1986 to May 2003, among 149 patients implanted with a TAH in our institution, 30 had a BSA of less than 1.7 m2 (Group I). Results were compared with the remaining 119 patients (Group II).


RESULTS
One patient in Group I experienced a fitting problem and was left with the chest open. Otherwise, in this group, the Day 1 cardiac index averaged 3.6 +/- 0.6 liter/min/m2, which was significantly higher than the 2.8 +/- 0.36 liter/min/m2 observed in Group II. Post-implantation central venous pressure and mean arterial pressure were similar in both groups: 14.7 +/- 3.8 mm Hg vs 14.5 +/- 4 mm Hg and 87 +/- 23 mm Hg vs 88 +/- 19 mm Hg, respectively. In Group I, survival on the device dramatically increased from 9% before 1992, to 36% between 1992 and 1997 and finally reached 75% after then. In the meantime, for the same time periods, global survival to hospital discharge increased from 9% to 36% and reached 50% after 1997. In Group II, global survival to hospital discharge was 25.5% before 1992, 34.6% between 1993 and 1997, and reached 52% thereafter.


CONCLUSIONS
The CardioWest TAH can be used in patients with a BSA between 1.5 m2 and 1.7 m2 with few fitting problems. In this group of patients, results are similar to those obtained in patients with a BSA greater than 1.8 m2.
Leprince
Pascal
P
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France. pascal.leprince@psl.ap-hop-paris.fr
Bonnet
Nicolas
N
Varnous
Shaida
S
Rama
Actar
A
Léger
Philippe
P
Ouattara
Alexandre
A
Landi
Marc
M
Szefner
Jacques
J
Gandjbakhch
Iradj
I
Pavie
Alain
A
D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D002648:Child; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006354:Heart, Artificial; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome