Experience With SynCardia Total Artificial Heart as a Bridge to Transplantation in 100 Patients

Jad Malas, Qiudong Chen, Akbarshakh Akhmerov, Louis Philippe Tremblay, Natalia Egorova, Aasha Krishnan, Jaime Moriguchi, Jon Kobashigawa, Lawrence Czer, Robert Cole, Dominic Emerson, Joanna Chikwe, Francisco Arabia, Fardad Esmailian

Research output: Contribution to journalArticlepeer-review


Background: The SynCardia temporary total artificial heart (TAH-t) is an effective bridge to transplantation for patients with severe biventricular failure. However, granular single-center data from high-volume centers are lacking. We report our experience with the first 100 TAH-t recipients. Methods: A prospective institutional database was used to identify 100 patients who underwent 101 TAH-t implantations between 2012 and 2022. Patients were stratified and compared according to Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 vs 2 or greater. Median follow-up on device support was 94 days (interquartile range, 33-276), and median follow-up after transplantation was 4.6 years (interquartile range, 2.1-6.0). Results: Overall, 61 patients (61%) were successfully bridged to transplantation and 39 (39%) died on TAH-t support. Successful bridge rates between INTERMACS profile 1 and INTERMACS profile 2 or greater patients were similar (55.6% [95% CI, 40.4%-68.3%] vs 67.4% [95% CI, 50.5%-79.6%], respectively; P = .50). The most common adverse events (rates per 100 patient-months) on TAH-t support included infection (15.8), ischemic stroke (4.6), reoperation for mediastinal bleeding (3.5), and gastrointestinal bleeding requiring intervention (4.3). The most common cause of death on TAH-t support was multisystem organ failure (n = 20, 52.6%). Thirty-day survival after transplantation was 96.7%; survival at 6 months, 1 year, and 5 years after transplantation was 95.1% (95% CI, 85.4%-98.4%), 86.6% (95% CI, 74.9%-93.0%), and 77.5% (95% CI, 64.2%-86.3%), respectively. Conclusions: Acceptable outcomes can be achieved in the highest acuity patients using the TAH-t as a bridge to heart transplantation.

Original languageEnglish
Pages (from-to)725-732
Number of pages8
JournalAnnals of Thoracic Surgery
Issue number3
StatePublished - Mar 2023


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