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Review
. 2020 Mar;9(2):81-88.
doi: 10.21037/acs.2020.02.09.

Total artificial heart: surgical technique in the patient with normal cardiac anatomy

Joshua S Chung  1 , Dominic Emerson  2 , Dominick Megna  2 , Francisco A Arabia  3
Affiliations
Review

Total artificial heart: surgical technique in the patient with normal cardiac anatomy

Joshua S Chung et al. Ann Cardiothorac Surg. 2020 Mar.

Abstract

Heart failure is a complex, growing problem with significant morbidity and mortality. Though heart transplantation remains the gold standard treatment for end-stage heart failure, there remains a national shortage of donor hearts. Mechanical circulatory support has provided an additional option for clinicians to support patients for the purposes of bridging patients to transplantation or to be used for destination therapy purposes. Despite generally favorable outcomes with univentricular support, in a subset of patients with biventricular heart failure, an isolated left ventricular assist device is not sufficient. Right ventricular failure has a negative impact on patient survival if not identified and treated promptly. The Total Artificial Heart (TAH) is the only Food and Drug Administration (FDA) approved artificial heart used for bridging patients to transplantation. Outcomes in patients who undergo implantation of the TAH at experienced centers have been good and reproducible.

Keywords: Total artificial heart (TAH); biventricular heart failure; mechanical circulatory support.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
SynCardia total artificial heart.
Figure 2
Figure 2
70 and 50 cc total artificial heart.
Figure 3
Figure 3
C2 external driver.
Figure 4
Figure 4
Freedom Driver allows increased mobility so patients can be discharged to home.
Figure 5
Figure 5
Cardiectomy for total artificial heart implantation.
Figure 6
Figure 6
Left quick connect anastomosis.
Figure 7
Figure 7
Left and right quick connect anastomoses.
Figure 8
Figure 8
All anastomoses are completed prior to connecting the TAH. A Gortex membrane is inserted along the left pulmonary veins.
Figure 9
Figure 9
Insert left ventricle first.
Figure 10
Figure 10
TAH fully implanted.
Video
Video
Total artificial heart: surgical technique in the patient with normal cardiac anatomy.
See this image and copyright information in PMC

References

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