title: Clinical indications for implantation of the total artificial heart.
abstract: The total artificial heart (TAH) is effective for bridging patients with biventricular heart failure (BiVHF) to transplantation. It consists of two pneumatic pumps with four mechanical valves that replace nearly the entire myocardium, thus also making it effective therapy for heart failure from alternative (ALT) anatomical and pathophysiological causes that preclude left ventricular assist device (LVAD). This report reviews the clinical indications and outcomes for TAH implantation at our institution from 2006 to 2012. We sought to characterize and compare survival to transplant for patients with BiVHF to those with ALT indications. The overall survival to transplant for all patients was 86% (57/66). There was a trend towards decreased survival to transplantation in the ALT group compared with the BiVHF group (77% vs. 93%, HR 0.42 [95% confidence interval 0.1, 1.7], log-rank test: p = 0.2). This was likely driven by certain high risk subgroups of allograft failure, LVAD failure, and acute postinfarct shock.
authors: From the *Division of Cardiology, Virginia Commonwealth University Medical Center, Richmond, Virginia; and †Division of Cardiothoracic Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia.
authors: Kristin L
authors: KL
authors: Thanavaro
authors: Daniel G
authors: DG
authors: Tang
authors: Vigneshwar
authors: V
authors: Kasirajan
authors: Keyur B
authors: KB
authors: Shah
mesh_terms: D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality*; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D008875:Middle Aged