Purpose: Biventricular support can be achieved using ventricular assist devices (BiVADs) or total artificial heart (TAH). The purpose of the present study was to compare survival between these two devices. Methods and Materials: We retrospectively reviewed data from two French teaching hospitals (Henri Mondor Hospital and La Pitié-Salpétrière Hospital) working in the same geographic area. We identified 152 patients undergoing primary, planned biventricular support using durable devices between 1996 and 2009. There were 133 (88%) males and mean age was 44.1 years. Seventy-one patients (47%) received a BiVAD (Henri Mondor hospital) and 81 (53%) patients had a TAH (La Pitié-Salpétrière hospital). Results: Preoperatively, BiVAD recipients had significantly higher ALAT (p=0.016) and ASAT levels (p=0.008). TAH recipients had higher rates of previous cardiac surgery (24% vs 7%, p=0.004) and preimplant ECLS (21% vs 0%, p=0.0001). Mean duration of support was 77.4 days per patient for the BiVADs group and 71.0 for TAH group (p=NS). Forty two (59%) BiVADs recipients were successfully bridged to transplantation (n=39, 55%) or recovery (n=3, 2%), whereas 47 patients (58%) underwent transplantation in the TAH group. Death while on support was not significantly different between groups (BiVADs group: n=29, 41% vs TAH group: n=34, 42%). Post-transplant actuarial survival in the BiVADs group was 76.6%, 70.6%, and 58.9% at 1, 3, and 5 years after transplantation, respectively, and was not significantly different from that observed in the TAH group (79.6%, 75.2%, and 72.4%, p=0.5). Conclusions: There were no significant differences in survival while on support and up to 5 years after heart transplantation in patients requiring biventricular support using either BiVADs or the TAH.

BiVAD or total artificial heart: is there a difference?

POZZI, Matteo;
2012

Abstract

Purpose: Biventricular support can be achieved using ventricular assist devices (BiVADs) or total artificial heart (TAH). The purpose of the present study was to compare survival between these two devices. Methods and Materials: We retrospectively reviewed data from two French teaching hospitals (Henri Mondor Hospital and La Pitié-Salpétrière Hospital) working in the same geographic area. We identified 152 patients undergoing primary, planned biventricular support using durable devices between 1996 and 2009. There were 133 (88%) males and mean age was 44.1 years. Seventy-one patients (47%) received a BiVAD (Henri Mondor hospital) and 81 (53%) patients had a TAH (La Pitié-Salpétrière hospital). Results: Preoperatively, BiVAD recipients had significantly higher ALAT (p=0.016) and ASAT levels (p=0.008). TAH recipients had higher rates of previous cardiac surgery (24% vs 7%, p=0.004) and preimplant ECLS (21% vs 0%, p=0.0001). Mean duration of support was 77.4 days per patient for the BiVADs group and 71.0 for TAH group (p=NS). Forty two (59%) BiVADs recipients were successfully bridged to transplantation (n=39, 55%) or recovery (n=3, 2%), whereas 47 patients (58%) underwent transplantation in the TAH group. Death while on support was not significantly different between groups (BiVADs group: n=29, 41% vs TAH group: n=34, 42%). Post-transplant actuarial survival in the BiVADs group was 76.6%, 70.6%, and 58.9% at 1, 3, and 5 years after transplantation, respectively, and was not significantly different from that observed in the TAH group (79.6%, 75.2%, and 72.4%, p=0.5). Conclusions: There were no significant differences in survival while on support and up to 5 years after heart transplantation in patients requiring biventricular support using either BiVADs or the TAH.
Heart failure; Mechanical circulatory support; Biventricular assist device; Total artificial heart
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/667764
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