title: Experience with more than 100 total artificial heart implants.
abstract: OBJECTIVE
  The SynCardia Total Artificial Heart (SynCardia Systems Inc, Tucson, Ariz) has been used as a bridge to cardiac transplantation in 930 patients worldwide and in 101 patients in our program. Our experience with SynCardia Total Artificial Heart implantation documents its indications, safety, and efficacy.
  
  
  METHODS
  Data regarding preoperative condition, mortality, and morbidity have been reviewed and analyzed.
  
  
  RESULTS
  From January 1993 to December 2009, 101 patients had bridge to transplant procedures with the SynCardia Total Artificial Heart. Ninety-one percent of cases were Interagency Registry for Mechanically Assisted Circulatory Support profile 1, and the remaining 9% of cases were failing medical therapy on multiple inotropic medications. The mean support time was 87 days (median, 53 days; range, 1-441 days). Pump outputs during support were 7 to 9 L/min. Adverse events included strokes in 7.9% of cases and take-back for hemorrhage in 24.7% of cases. Survival to transplantation was 68.3%. Causes of death of 32 patients on device support included multiple organ failure (13), pulmonary failure (6), and neurologic injury (4). Survival after transplantation at 1, 5, and 10 years was 76.8%, 60.5%, and 41.2%, respectively. The longest-term survivor is currently alive 16.4 years postimplantation.
  
  
  CONCLUSIONS
  These patients were not candidates for left ventricular assist device therapy and were expected to die. The SynCardia Total Artificial Heart offers a real alternative for survival with a reasonable complication rate in appropriate candidates who otherwise might have been assigned to hospice care.
authors.affiliation: Department of Surgery, University of California San Diego, San Diego, CA 92103, USA. jackcope3@gmail.com
authors.forename: Jack G
authors.initials: JG
authors.lastname: Copeland
authors.forename: Hannah
authors.initials: H
authors.lastname: Copeland
authors.forename: Monica
authors.initials: M
authors.lastname: Gustafson
authors.forename: Nicole
authors.initials: N
authors.lastname: Mineburg
authors.forename: Diane
authors.initials: D
authors.lastname: Covington
authors.forename: Richard G
authors.initials: RG
authors.lastname: Smith
authors.forename: Mark
authors.initials: M
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000601:surgery*; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D012042:Registries; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult