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Arabía FA, Murray CF, Cantor R, Deng L, Gopalan R, Amabile O, Kalya A, Tasset MR, Colón MJ, Smith R, Kirklin JK. Heart Transplant Outcomes After Total Artificial Heart. Transplant Proc 2023; 55:1664-1673. [PMID: 37453855 DOI: 10.1016/j.transproceed.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND We sought to compare heart transplant (HTX) outcomes from patients with a total artificial heart (TAH), biventricular assist device (BiVAD), or left ventricular assist device (LVAD) as a bridge to transplant (BTT). Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)-Scientific Registry of Transplant Recipients (SRTR) created a dataset with TAH or durable mechanical circulatory support (MCS) who reached HTX between 2006 and 2015. METHODS The retrospective analysis compared TAH outcomes with those with a BiVAD or LVAD before HTX. The primary outcome was posttransplant survival at 1, 36, and 60 months. Secondary outcomes included simultaneous heart-kidney transplants, donor characteristics, and mortality risk factors. INTERMACS-SRTR cohort had, at the time of HTX, 2762 patients with LVAD; 205 BiVAD (139 durable and 66 temporary RVAD); 176 TAH (6 prior HeartMate II). RESULTS Sixty months after HTX, mortality rates were 16.5% in the total group: LVAD 15.2%, BiVAD 22.4%, and TAH 29%. Survival differed between the LVAD, the TAH, and BiVAD but not between the BiVAD and TAH groups. One-year survival and complication rates were similar across groups-there was no difference in survival by donor age in the overall cohort. There was a difference in TTD based on recipient age in the LVAD group but not in BiVAD or TAH groups. Occurrence of HTX-kidney and post-transplant dialysis were higher in the TAH versus LVAD and BiVAD groups. CONCLUSIONS The TAH is an efficacious BTT. Refinements in technology and patient selection may improve outcomes.
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Affiliation(s)
- Francisco A Arabía
- Advanced Heart Program-University Medical Group and University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.
| | | | - Ryan Cantor
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama
| | - Luqin Deng
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama
| | - Radha Gopalan
- University of Arizona College of Medicine and Center for Advanced Heart Failure/Mechanical Circulatory Support and Transplant, Banner-University Medical Center Phoenix, Phoenix, Arizona
| | - Orazio Amabile
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Anantharam Kalya
- University of Arizona College of Medicine and Center for Advanced Heart Failure/Mechanical Circulatory Support and Transplant, Banner-University Medical Center Phoenix, Phoenix, Arizona
| | - Mark R Tasset
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Modesto J Colón
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Richard Smith
- Banner-University Medical Center Tucson and South Tucson, Tucson, Arizona
| | - James K Kirklin
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama
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Schullerer D, Schurter D, Meinhold A, Paal S, Staubli S, Bichsel I, Dave H, Cesnjevar R, Schweiger M. Safety issues with an inter-hospital transport of a patient with a Berlin Heart Excor biventircular assist device. Artif Organs 2023; 47:582-588. [PMID: 36356800 DOI: 10.1111/aor.14455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/26/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Interhospital transfers of pediatric patients on the Berlin Heart Excor have been published on an occasional basis. METHODS Nowadays medicine evolves away from just feasibility towards quality and safety issues. Management tools like risk analysis have found their way into clinical practice. RESULTS Exemplary, we present a case of a 20 months old boy on a Berlin Heart BiVAD Excor who underwent a 224 km ground transport. After a systematic review of the published literature, we describe our safety management with the aim was to provide highest quality of care for the transport. CONCLUSION Besides a risk analysis, we also describe our training and simulation protocol.
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Affiliation(s)
| | - David Schurter
- Schutz & Rettung Zurich, Ambulance Service, Zurich, Switzerland
| | - Anke Meinhold
- Paediatric Cardiac Intensive Care, University Children's Hospital, Zurich, Switzerland
| | - Sebastian Paal
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Susanne Staubli
- Visualisation, University Children's Hospital, Zurich, Switzerland
| | - Isabelle Bichsel
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Hitendu Dave
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Robert Cesnjevar
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Martin Schweiger
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
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de By TMMH, Schweiger M, Hussain H, Amodeo A, Martens T, Bogers AJJC, Damman K, Gollmnan-Tepeköylü C, Hulman M, Iacovoni A, Krämer U, Loforte A, Napoleone CP, Němec P, Netuka I, Özbaran M, Polo L, Pya Y, Ramjankhan F, Sandica E, Sliwka J, Stiller B, Kadner A, Franceschini A, Thiruchelvam T, Zimpfer D, Meyns B, Berger F, Miera O. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report. Eur J Cardiothorac Surg 2022; 62:6618527. [PMID: 35758622 DOI: 10.1093/ejcts/ezac355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/23/2022] [Accepted: 06/25/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Martin Schweiger
- Department of Congenital Pediatric Surgery, Children's Hospital Zürich, Zürich, Switzerland
| | | | | | | | - Ad J J C Bogers
- Department of Cardio-thoracic surgery, Erasmus MC, Rotterdam, Netherlands
| | - Kevin Damman
- University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | | | | | - Ulrike Krämer
- Department of Pediatric Intensive Care, Erasmus MC, Rotterdam, Netherlands
| | | | - Carlo Pace Napoleone
- Pediatric Cardiac Surgery Department, Regina Margherita Children's Hospital, Torino, Italy
| | - Petr Němec
- Center for Cardiovascular and Transplant Surgery Brno
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | - Luz Polo
- La Paz University Hospital, Madrid, Spain
| | - Yuri Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | | | - Eugen Sandica
- Clinic for Pediatric Cardiac Surgery and Congenital Heart Defects, Heart and Diabetes Centre North Rhine-Westphalia, Bad Oeynhausen, Germany
| | - Joanna Sliwka
- Department of Cardiac Surgery, Transplantology and Vascular Surgery, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Brigitte Stiller
- Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Germany
| | - Alexander Kadner
- Department of Herz- und Gefässchirurgie, University Hospital Bern, Switzerland
| | | | | | | | - Bart Meyns
- Katholieke Universiteit Leuven, Leuven, Belgium
| | - Felix Berger
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Oliver Miera
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
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Deshpande S, Alsoufi B. Meeting needs-pushing boundaries: Mechanical circulatory support in children; year in review. J Thorac Cardiovasc Surg 2021; 162:400-404. [PMID: 33994204 DOI: 10.1016/j.jtcvs.2021.04.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Shriprassad Deshpande
- Department of Cardiology and Cardiac Critical Care, Children's National Hospital, Washington, DC
| | - Bahaaldin Alsoufi
- Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, Ky.
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Eulert-Grehn JJ, Lanmüller P, Starck C, Hennig F, Jacobs S, Falk V, Potapov E. Continuous-flow biventricular mechanical support implantation strategies. Ann Cardiothorac Surg 2021; 10:408-410. [PMID: 34159127 DOI: 10.21037/acs-2021-cfmcs-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jaime-Jürgen Eulert-Grehn
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Pia Lanmüller
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Felix Hennig
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Stephan Jacobs
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany.,Department of Cardiothoracic Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Health Sciences, ETH Zurich, Translational Cardiovascular Technologies, Zurich, Switzerland
| | - Evgenij Potapov
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany
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