Results of the first 100 patients who received Symbion Total Artificial Hearts as a bridge to cardiac transplantation

Abstract

Between August 8, 1985 and April 1, 1988, 100 patients in 22 centers underwent Symbion Total Artificial Heart (TAH) (Symbion, Inc., Salt Lake City, Utah) implantation as a bridge to cardiac transplant. Thirty patients received the Symbion J7-100, and 70 patients received Symbion J7-70 implants. Eighty-seven patients were men and 13 were women; mean age was 42 years, and mean weight was 73 kg. The time spent on the device ranged from 1 to 243 days, for a mean of 23 days. Sixty-eight patients underwent cardiac transplantation, with a 69% 30-day survival rate and a 46% (31 of 68) long-term survival rate. The majority of the patients had ischemic (52) or idiopathic (36) cardiomyopathies. Indications for implantation of the TAH occurred most frequently in patients whose condition deteriorated while awaiting transplant (34) or who were admitted in acute cardiogenic shock (27). There was an 8.7% incidence of thromboembolic events (four cerebrovascular accidents, five transient ischemic attacks). Multivariant analysis was performed to determine the effect of various factors on the patients' ability to undergo transplantation and then ultimate survival. The results indicate a need for further clinical investigation in patient selection and appropriate timing for implantation of the TAH.