Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;9(2):104-109.
doi: 10.21037/acs.2020.02.15.

The total artificial heart in pediatrics: outcomes in an evolving field

Chet R Villa  1 , Ryan A Moore  1 , David L Morales  1 , Angela Lorts  1
Affiliations

The total artificial heart in pediatrics: outcomes in an evolving field

Chet R Villa et al. Ann Cardiothorac Surg. 2020 Mar.

Abstract

Background: The use of the SynCardia temporary total artificial heart (TAH-t) in adults has increased with time. The development of the smaller, 50 cc TAH-t has expanded the potential applications of the device in children. We sought to describe the evolving use of the TAH-t over time and describe outcomes in the current era.

Methods: The SynCardia database was queried to identify all pediatric patients ≤18 years of age implanted with the device between December 1985 and October 2019. Patient demographics, clinical outcome and support characteristics collected.

Results: Fifty-one children were supported, 36 with the 70 cc TAH-t and 15 with the 50 cc TAH-t with a total support time of 6,243 days. The number of implants has increased with time (19 between 2015 and 2019). A total of 13 patients have been converted to Freedom Driver support, seven 50 cc TAH-t and six 70 cc TAH-t. The majority of implants in the last 5 years (15/19, 79%) have been with the 50 cc TAH-t. The most common diagnosis was dilated cardiomyopathy [24 (47%)] and the average age at the time of implant was 16±2 years old. Overall survival for the patient cohort was 71%.

Conclusions: The use of the SynCardia TAH-t to support children with end-stage heart failure has increased over time. Clinical outcomes with both the 50 cc and 70 cc TAH-t are similar to reported outcomes in adults who require TAH-t or other methods of biventricular support.

Keywords: Total artificial heart; congenital heart disease; pediatrics.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Dr. Lorts is a consultant for SynCardia, Abbott, Medtronic, and Berlin Heart. Dr. Morales is a consultant for Cormatrix/Azyio, Berlin Heart, SynCardia, Abbott, Medtronic and instructor for SynCardia and Berlin Heart. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Number of pediatric TAH-t implants in 5-year increments stratified by device size.
Video
Video
The total artificial heart in pediatrics: outcomes in an evolving field.
See this image and copyright information in PMC

References

    1. Rossano JW, Singh TP, Cherikh WS, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Twenty-second pediatric heart transplantation report - 2019; Focus theme: Donor and recipient size match. J Heart Lung Transplant 2019;38:1028-41. 10.1016/j.healun.2019.08.002 - DOI - PMC - PubMed
    1. Wells D, Villa CR, Simón Morales DL. The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017. doi: .10.1053/j.pcsu.2016.09.004 - DOI - PubMed
    1. Moore RA, Lorts A, Madueme PC, et al. Virtual implantation of the 50 cc SynCardia total artificial heart. J Heart Lung Transplant 2016;35:824-7. 10.1016/j.healun.2015.12.026 - DOI - PubMed
    1. Beasley GS, Allen K, Pahl E, et al. Successful Bridge to Transplant in a Pediatric Patient Using the SynCardia 50 cc Total Artificial Heart. ASAIO J 2020;66:e33-5. 10.1097/MAT.0000000000000968 - DOI - PubMed
    1. Rossano JW, Goldberg DJ, Fuller S, et al. Successful use of the total artificial heart in the failing Fontan circulation. Ann Thorac Surg 2014;97:1438-40. 10.1016/j.athoracsur.2013.06.120 - DOI - PubMed