title: Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart.
abstract: BACKGROUND
  Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH).
  
  
  METHODS
  We studied 66 consecutive patients implanted with the TAH at our institution from 2006 through 2012 and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes.
  
  
  RESULTS
  Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively. INTERMACS profile 1 patients had decreased 6-month survival on the device compared with those in profiles 2-4 (74% vs 95%, log rank: P = .015). For the 50 patients surviving to heart transplantation, the 1-year posttransplant survival was 82%. There was no difference in 1-year survival when comparing patients in the INTERMACS 1 profile with less severe profiles (79% vs 84%; log rank test P = .7; hazard ratio [confidence interval] 1.3 [0.3-4.8]).
  
  
  CONCLUSIONS
  Patients implanted with the TAH as INTERMACS profile 1 had reduced survival to transplantation compared with less sick profiles. INTERMACS profile at the time of TAH implantation did not affect 1-year survival after heart transplantation.
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia. Electronic address: kshah@mcvh-vcu.edu.
authors.forename: Keyur B
authors.initials: KB
authors.lastname: Shah
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Thanavaro
authors.affiliation: Department of Cardiothoracic Surgery, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Tang
authors.affiliation: Department of Cardiothoracic Surgery, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Quader
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Anit K
authors.initials: AK
authors.lastname: Mankad
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Inna
authors.initials: I
authors.lastname: Tchoukina
authors.affiliation: School of Nursing, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Leroy R
authors.initials: LR
authors.lastname: Thacker
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Smallfield
authors.affiliation: Department of Cardiothoracic Surgery, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Gundars
authors.initials: G
authors.lastname: Katlaps
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hess
authors.affiliation: Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Cooke
authors.affiliation: Department of Cardiothoracic Surgery, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Vigneshwar
authors.initials: V
authors.lastname: Kasirajan
mesh_terms: D000328:Adult; D002423:Cause of Death; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods* / Q000401:mortality; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists
keywords: Artificial heart; heart failure; heart transplantation; survival