CardioWest (Jarvik) total artificial heart: a single-center experience with 42 patients.
BACKGROUND
When implanted in patients with biventricular failure, the CardioWest total artificial heart has asserted itself over time as a reliable bridge-to-transplant device that as yet is used by only a few international teams. The aim of this single-center retrospective study is to assess both the comorbidity and survival of patients awaiting heart transplants while receiving circulatory support with a CardioWest total artificial heart.


METHODS
From 1990 to December 2006, 42 patients received a CardioWest total artificial heart at our center. Mean age at the time of implantation was 45.7 +/- 9.5 years, and 40 patients (95%) were men. Idiopathic or dilated cardiomyopathy was diagnosed in 45.2% (n = 19) of the patients and ischemic cardiomyopathy in 42.8% (n = 18). Average body surface area was 1.9 +/- 0.22 m(2).


RESULTS
Duration of support was 1 to 292 days (mean, 101 +/- 86 days). Twelve patients died (28.5%) while receiving device support, and 30 patients (71.5%) underwent transplantation. Actuarial survival rates for the transplanted patients were 90% (n = 25), 81% (n = 14), and 76% (n = 10) at 1, 5, and 10 years, respectively. Causes of death during device support included multiorgan failure in 6 (50%), sepsis in 2, acute respiratory distress syndrome in 2, alveolar hemorrhage in 1, and other cause in 1. There were no device malfunctions that led to patient death. Adverse events included stroke in 3 patients (7%) and infections in 35 patients (85%) during support.


CONCLUSIONS
The CardioWest total artificial heart is an excellent bridge-to-transplant device for patients with biventricular failure. Our study demonstrates excellent safety, reliability, and efficiency. Exceptional outcome after transplantation underlines its capacity to aid in end-organ recovery.
Roussel
Jean Christian
JC
Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, Nantes Hospital University, Nantes, France. jeanchristian.roussel@chu-nantes.fr
Sénage
Thomas
T
Baron
Olivier
O
Périgaud
Christian
C
Habash
Oussama
O
Rigal
Jean Christophe
JC
Treilhaud
Michèle
M
Trochu
Jean Noel
JN
Despins
Philippe
P
Duveau
Daniel
D
D000328:Adult; D000704:Analysis of Variance; D002302:Cardiac Output / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000601:surgery*; D016027:Heart Transplantation; D006354:Heart, Artificial; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011336:Probability; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D015996:Survival Rate; D013997:Time Factors; D009927:Tissue and Organ Procurement; D014850:Waiting Lists