Background: Patients with severe irreversible biventricular heart failure may require support with the total artificial heart (TAH). These patients are usually Intermacs level 1 or 2 and are high risk for morbidity and mortality before and after heart transplantation. As we have one of the largest experiences with TAH implantation, we chose to describe our experience with our patients using similar protocols.

Methods: Between January 2012 and December 2014 we identified 48 heart failure patients (average Intermacs level 1.9 ± 0.9) who required TAH support. Characterization of these patients included 6-month survival and/or transplantation, complications including stroke, bleeding, driveline infection, gastrointestinal (GI) bleed. The prevalence of discharge home with Freedom Driver was also assessed. Furthermore, for those patients who underwent heart transplantation, outcomes assessed included post-transplant survival, pre-transplant sensitization, rejection and primary graft dysfunction (PGD).

Results: 48 patients underwent TAH implantation with a 72.9% (35/48) 6-month survival and/or transplantation rate. Complications were as follows: there was 22.9% post-implant stroke, 8.3% post-implant bleeding (brain), 25.0% post-implant GI bleeding, and 6.3% (3/48) post-implant driveline infection (see table). 53.3% (24/48) of the patients were discharged home on a Freedom Driver. 12 patients underwent heart transplantation with a 6-month and 12-month survival of 100.0%. Pre transplant sensitization with a PRA > 10% was 22.9% (11/48). No patient developed rejection or developed moderate to severe PGD post-transplant.

Conclusion: Patients undergoing TAH implantation have acceptable survival/transplantation, but complications are frequent. Post-transplant outcome appears respectable.

CITATION INFORMATION: Arabia F, Kittleson M, Czer L, Chang D, Aintablian T, Passano E, Rodriguez G, Runyon C, Kobashigawa J, Moriguchi J. The Largest Single Center Experience with Total Artificial Heart Implantation: Characterization of Outcome. Am J Transplant. 2016;16 (suppl 3).

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