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Medizinische Klinik, Intensivmedizin... Sep 2015To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. (Review)
Review
BACKGROUND
To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure.
OBJECTIVES
This article presents the indications, contraindications, implantation procedere and postoperative treatment.
MATERIAL AND METHODS
In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™.
RESULTS
The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented.
CONCLUSION
The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.
Topics: Austria; Contraindications; Critical Care; Ethics, Medical; Guideline Adherence; Heart Failure; Heart Transplantation; Heart, Artificial; Humans; Monitoring, Physiologic; Prosthesis Design; Shock, Cardiogenic; Survival Rate
PubMed: 26296374
DOI: 10.1007/s00063-015-0060-9 -
The Hastings Center Report Jan 2021The lead article in this January-February 2021 issue-the first of the Hastings Center Report's fiftieth year of publication-does not set out to change medicine. It tries...
The lead article in this January-February 2021 issue-the first of the Hastings Center Report's fiftieth year of publication-does not set out to change medicine. It tries instead to understand it. In "A Heart without Life: Artificial Organs and the Lived Body," Mary Jean Walker draws on work in phenomenology and on empirical research with people who have received artificial heart devices to argue that such devices may have two very different effects on how a patient experiences the body and the self. Several other pieces in this issue address the ongoing slew of patient care and health policy problems surrounding the Covid-19 pandemic, and a special report titled Democracy in Crisis: Civic Learning and the Reconstruction of Common Purpose considers the requirements for public involvement in policy-making about bioethical issues.
Topics: COVID-19; Health Policy; Heart, Artificial; Humans; Self Concept
PubMed: 33630325
DOI: 10.1002/hast.1209 -
Heart & Lung : the Journal of Critical... Jul 1985
Review
Topics: Animals; Diastole; Heart; Heart Rate; Heart Transplantation; Heart, Artificial; History, 19th Century; History, 20th Century; Humans; Male; Middle Aged; Monitoring, Physiologic; Postoperative Care; Postoperative Complications; Preoperative Care; Systole; United States
PubMed: 3891686
DOI: No ID Found -
British Medical Bulletin 1997The use of a mechanical device to support a failing heart is one of the greatest challenges in cardiothoracic practice. Many different approaches are being considered,... (Review)
Review
The use of a mechanical device to support a failing heart is one of the greatest challenges in cardiothoracic practice. Many different approaches are being considered, but they share the use of many advanced engineering principles. Power supplies and the interface between artificial surfaces and the blood remain areas of difficulty. The accent is moving from console driven devices with drive lines which must cross the body wall to reach the pump, towards smaller control packs, with inductive coupling to fully contained pumps. More attention is focused on the use of axial pumps lying within the lumena of the great vessels and the ventricles. Despite the wideheld belief that mechanical pumps must confer survival advantage to the recipients, there has been no prospective study demonstrating any advantage over medical management of the failing heart. Economic considerations must be taken into account if the technology is to be available to everyone with heart failure.
Topics: Equipment Design; Forecasting; Heart Diseases; Heart, Artificial; Heart-Assist Devices; Humans
PubMed: 9536522
DOI: 10.1093/oxfordjournals.bmb.a011642 -
Artificial Organs Feb 2021
Topics: Animals; Forecasting; Heart, Artificial; History, 20th Century; History, 21st Century; Humans; Russia
PubMed: 33270245
DOI: 10.1111/aor.13860 -
Expert Review of Medical Devices Oct 2018Since the first total artificial heart (TAH) surgery in a human patient performed in 1969, over 1300 devices have been implanted worldwide. Patients are benefiting from... (Review)
Review
Since the first total artificial heart (TAH) surgery in a human patient performed in 1969, over 1300 devices have been implanted worldwide. Patients are benefiting from increased lengths of durable support and indications have expanded beyond biventricular failure including allograft failure, severe restrictive disease, and complex congenital anomalies. Areas covered: The role of the TAH in biventricular failure, rates of successful bridge-to-transplant (BTT), and survival compared with biventricular assist devices (BiVADs) are discussed and differences between TAH and LVAD patient populations are highlighted. The device's niche role in physiologies not amenable to single ventricle support is further described. New developments such as the 50cc Syncardia, continuous flow mechanisms (BiVACOR and Cleveland Clinic CF-TAH), and a bioprosthetic model (CARMAT) are discussed. Literature review was conducted utilizing the PubMed database selecting published research, database analyses, and case reports under 'total artificial heart' relevant to the paper's aims. Expert commentary: TAH patients have high rates of successful BTT and survival on par with BiVAD-supported patients. Ongoing developments including decreased device size, continuous flow mechanisms, and use of bioprosthetic materials will ensure that the TAH will have an increasing role in advanced heart failure with increased device longevity and decreased post-implant complications.
Topics: Bioprosthesis; Heart Failure; Heart Transplantation; Heart, Artificial; Heart-Assist Devices; Humans; Models, Cardiovascular
PubMed: 30221561
DOI: 10.1080/17434440.2018.1524294 -
Anesthesia and Analgesia May 2017Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation... (Review)
Review
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.
Topics: Critical Care; Heart Transplantation; Heart, Artificial; Heart-Assist Devices; Humans; Perioperative Care
PubMed: 28107271
DOI: 10.1213/ANE.0000000000001851 -
Dimensions of Critical Care Nursing :...Patients with isolated left ventricular failure may have positive outcomes after being implanted with a left ventricular assist device. Unfortunately, almost half of... (Review)
Review
BACKGROUND
Patients with isolated left ventricular failure may have positive outcomes after being implanted with a left ventricular assist device. Unfortunately, almost half of patients with heart failure and reduced ejection fraction also have evidence of right ventricular dysfunction. For a subset of this population with severe biventricular failure, or those who develop right ventricular dysfunction after left ventricular assist device implantation, patients may necessitate biventricular assist devices or the total artificial heart.
OBJECTIVES
This overview of mechanical circulatory support devices will enhance nurses' ability to differentiate criteria for implantation, current practice, and outcomes with a focus on durable ventricular assist devices and the total artificial heart.
METHODS
A review of the literature involved searching CINAHL and PubMed databases using keywords biventricular assist devices, total artificial heart, and durable mechanical circulatory support. Results were narrowed to articles based on adults, 18 years or older. Seventy-eight relevant articles were identified, and 8 articles compared the durable biventricular assist devices.
RESULTS
Similar patient outcomes were found when comparing the use of left ventricular assist devices as biventricular support versus the total artificial heart.
DISCUSSION
The decision to implant the appropriate durable mechanical circulatory support for a patient in biventricular failure is complex and dependent on patient factors.
Topics: Adult; Heart Failure; Heart, Artificial; Heart-Assist Devices; Humans; Treatment Outcome; Ventricular Dysfunction, Right
PubMed: 33560630
DOI: 10.1097/DCC.0000000000000454 -
Expert Review of Medical Devices 2016A total artificial heart (TAH) is the sole remaining option for patients with biventricular failure who cannot be rescued by left ventricular assist devices (LVADs)... (Review)
Review
A total artificial heart (TAH) is the sole remaining option for patients with biventricular failure who cannot be rescued by left ventricular assist devices (LVADs) alone. However, the pulsatile TAH in clinical use today has limitations: large pump size, unknown durability, required complex anticoagulation regimen, and association with significant postsurgical complications. That pump is noisy; its large pneumatic driving lines traverse the body, with bulky external components for its drivers. Continuous-flow pumps, which caused a paradigm shift in the LVAD field, have already contributed to the rapidly evolving development of TAHs. Novel continuous-flow TAHs are only in preclinical testing or developmental stages. We here review the current state of TAHs, with recommended requirements for the TAH of the future.
Topics: Animals; Cost-Benefit Analysis; Heart Failure; Heart, Artificial; Heart-Assist Devices; Humans; Quality of Life; Reproducibility of Results
PubMed: 26732059
DOI: 10.1586/17434440.2016.1136212 -
Seminars in Thoracic and Cardiovascular... 2008End-stage congestive heart failure remains the leading cause of death in the United States. Despite advances in medical treatment, it also remains the most common reason... (Review)
Review
End-stage congestive heart failure remains the leading cause of death in the United States. Despite advances in medical treatment, it also remains the most common reason for admission to the hospital. The gold standard of treatment for the failing heart, orthotopic heart transplantation, is limited by a shortage of donor hearts. There are also a significant number of patients who are not transplant candidates due to comorbid conditions and/or inability to tolerate immunosuppressive therapy. To meet the need for this latter group, the medical field has embraced ventricular assist device (VAD) therapy to extend survival and improve quality-of-life for the end-stage cardiac patient. This therapy, however, has been currently limited to the failing left ventricle and is still fraught with complications that limit long-term and widespread use. The total artificial heart, as currently available with two devices, is rapidly becoming the treatment of choice for biventricular failure.
Topics: Heart Failure; Heart Ventricles; Heart, Artificial; Humans; Prosthesis Design; Prosthesis Implantation; Treatment Outcome
PubMed: 19038735
DOI: 10.1053/j.semtcvs.2008.08.006