title: TandemHeart device as rescue therapy in the management of acute heart failure.
abstract: BACKGROUND
  The TandemHeart device (THD) is a pump system that can be deployed percutaneously (PC) or via conventional surgical (CS) cannulation; it is capable of supporting one or both ventricles. It is a versatile system designed for use as a rescue device in acute heart failure and as a bridge to decision in moribund patients.
  
  
  METHODS
  Retrospective analysis was conducted on all patients who underwent a THD implant; either PC or CS; at our institution. Univariate analysis was done using Fisher's exact and Chi-square tests for categorical variables and Wilcoxon Rank Sum test for continuous ones.
  
  
  RESULTS
  51 adult patients were identified: 10 PC and 41 CS. Mean age was 58.9 ± 12.8 years, and 31% were female. In hospital mortality was 61%. Univariate predictors of death were prolonged support (74% versus 46%, P = .04) and higher lactic acid levels (5.3 ± 4.9 versus 2.3 ± 1.9 mmol/L, P = .012). The length of stay (LOS) for survivors was 59.8 ± 30.0 days.
  
  
  CONCLUSIONS
  Uni- or bi-ventricular unloading can be successfully achieved using the THD, either trans-thoracically or percutaneously, with an acceptable complication profile.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert-Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Siyamek
authors.initials: S
authors.lastname: Neragi-Miandoab
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert-Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert-Einstein College of Medicine, Bronx, NY, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: D'Alessandro
mesh_terms: D015984:Causality; D015897:Comorbidity; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000295:instrumentation / Q000401:mortality* / Q000706:statistics & numerical data; D012770:Shock, Cardiogenic / Q000401:mortality* / Q000517:prevention & control*; D015996:Survival Rate; D016896:Treatment Outcome