Division of Thoracic and Cardiovascular Surgery, University of Louisville, Louisville, KY, USA.
Panminerva Med. 2011 Sep;53(3):141-54.
In the 1960s, cardiac surgeons and biomedical engineers pioneered the development of total artificial hearts (TAH) for the treatment of left and right heart failure. As we mark the 10th anniversary of the first implantation of the AbioCor device, the use of TAH has been limited, having failed to reach its envisioned potential and promise as an alternative therapy to heart transplantation. The Syncardia/CardioWest device, originally developed 30 years ago as the Jarvik TAH and later renamed the CardioWest TAH, continues to be used clinically in over 50 centers within the US and Europe having supported over 900 patients worldwide. Syncardia continues to develop TAH technology as evidenced by their recent introduction of a new portable pneumatic driver that enables patients to be discharged from the hospital. In contrast to TAH devices, continuous flow ventricular assist devices (VAD) have made tremendous technological strides and are rapidly gaining widespread clinical acceptance. The VAD technology has demonstrated extraordinary safety and reliability records through evolving technologies, advanced biocompatible materials, and improved patient management. Subsequently, the number of TAH implantations remains low compared to the growth in LVAD implants. Nonetheless, the Syncardia/CardioWest TAH remains an important and viable option for patients with severe biventricular failure and end organ dysfunction. Overall, a 79% survival rate has been achieved in patients supported with a Syncardia/CardioWest TAH as bridge-to-transplantation. In this review article, a brief history on the evolution of TAH devices, their current use and emerging use of evolving continuous flow VAD technology as chronic biventricular and TAH device systems are presented.
在 20 世纪 60 年代，心脏外科医生和生物医学工程师开创了全人工心脏（TAH）的发展，用于治疗左心和右心衰竭。随着 AbioCor 装置首次植入的 10 周年纪念日的到来，TAH 的使用受到了限制，未能达到其作为心脏移植替代疗法的预期潜力和承诺。Syncardia/CardioWest 装置最初是作为 Jarvik TAH 开发的，后来更名为 CardioWest TAH，在美国和欧洲的 50 多个中心继续临床使用，为全球 900 多名患者提供支持。Syncardia 通过最近引入新的便携式气动驱动器来为患者提供支持，从而继续开发 TAH 技术，使患者能够从医院出院。与 TAH 装置不同，连续流心室辅助装置（VAD）在技术上取得了巨大的进步，并迅速获得广泛的临床认可。VAD 技术通过不断发展的技术、先进的生物相容性材料和改进的患者管理，展示了非凡的安全性和可靠性记录。因此，与 LVAD 植入物的增长相比，TAH 植入物的数量仍然较低。尽管如此，Syncardia/CardioWest TAH 仍然是严重双心室衰竭和终末器官功能障碍患者的重要可行选择。总的来说，使用 Syncardia/CardioWest TAH 作为桥接移植的患者的存活率达到了 79%。在这篇综述文章中，简要介绍了 TAH 装置的发展历史、目前的用途以及新兴的连续流 VAD 技术作为慢性双心室和 TAH 装置系统的用途。
