Cardiopulmonary exercise testing responses to different external portable drivers in a patient with a CardioWest Total Artificial Heart.
Management of patients treated with CardioWest Total Artificial Heart (CW-TAH) as a bridge to heart transplantation (HTx) is complicated by difficulties in determining the optimal timing of transplantation. We present a case of a 53-year-old man supported as an outpatient with a CW-TAH, whose condition deteriorated following exchange of the portable driver. The patient was followed-up with serial cardiopulmonary exercise testing (CPET) which demonstrated a fall of peak VO2 to below 12 ml/kg/min following driver substitution, and the patient was subsequently treated with urgent orthotopic HTx. This case highlights the potential utility of CPET as a means for monitoring and indicating timing of HTx in patients with CW-TAH, as well as the potential for clinical deterioration following portable driver substitution.
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy. v.tarzia@gmail.com.
Vincenzo
V
Tarzia
Division of Respiratory Pathophysiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padua, Italy.
Fausto
F
Braccioni
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy.
Giacomo
G
Bortolussi
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy.
Edward
E
Buratto
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy.
Michele
M
Gallo
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy.
Tomaso
T
Bottio
Division of Respiratory Pathophysiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padua, Italy.
Andrea
A
Vianello
Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Via Giustiniani 2, 35128, Padua, Italy.
Gino
G
Gerosa
D005080:Exercise Test; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure
Cardiopulmonary exercise test; External driver; Heart transplantation; Total artificial heart