The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents

Thomas D. Ryan, John Jefferies, Farhan Zafar, Angela Lorts, David L.S. Morales

Research output: Contribution to journalReview article

27 Citations (Scopus)

Abstract

Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

Original languageEnglish (US)
Pages (from-to)8-14
Number of pages7
JournalASAIO Journal
Volume61
Issue number1
DOIs
StatePublished - Jan 13 2015
Externally publishedYes

Fingerprint

Artificial heart
Artificial Heart
Heart Diseases
Heart Failure
Transplants
Dialysis
Complementary Therapies
Allografts
Renal Dialysis
Therapeutics
History
Morbidity
Kidney
Equipment and Supplies
Mortality
Growth

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents. / Ryan, Thomas D.; Jefferies, John; Zafar, Farhan; Lorts, Angela; Morales, David L.S.

In: ASAIO Journal, Vol. 61, No. 1, 13.01.2015, p. 8-14.

Research output: Contribution to journalReview article

Ryan, Thomas D. ; Jefferies, John ; Zafar, Farhan ; Lorts, Angela ; Morales, David L.S. / The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents. In: ASAIO Journal. 2015 ; Vol. 61, No. 1. pp. 8-14.
@article{dcb7ff7a58d341ae977c6d8e4eb448fa,
title = "The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents",
abstract = "Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.",
author = "Ryan, {Thomas D.} and John Jefferies and Farhan Zafar and Angela Lorts and Morales, {David L.S.}",
year = "2015",
month = "1",
day = "13",
doi = "10.1097/MAT.0000000000000156",
language = "English (US)",
volume = "61",
pages = "8--14",
journal = "ASAIO Journal",
issn = "1058-2916",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents

AU - Ryan, Thomas D.

AU - Jefferies, John

AU - Zafar, Farhan

AU - Lorts, Angela

AU - Morales, David L.S.

PY - 2015/1/13

Y1 - 2015/1/13

N2 - Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

AB - Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

UR - http://www.scopus.com/inward/record.url?scp=84929044132&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929044132&partnerID=8YFLogxK

U2 - 10.1097/MAT.0000000000000156

DO - 10.1097/MAT.0000000000000156

M3 - Review article

VL - 61

SP - 8

EP - 14

JO - ASAIO Journal

JF - ASAIO Journal

SN - 1058-2916

IS - 1

ER -