Villa Chet R, Moore Ryan A, Morales David L, Lorts Angela
The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Ann Cardiothorac Surg. 2020 Mar;9(2):104-109. doi: 10.21037/acs.2020.02.15.
The use of the SynCardia temporary total artificial heart (TAH-t) in adults has increased with time. The development of the smaller, 50 cc TAH-t has expanded the potential applications of the device in children. We sought to describe the evolving use of the TAH-t over time and describe outcomes in the current era.
The SynCardia database was queried to identify all pediatric patients ≤18 years of age implanted with the device between December 1985 and October 2019. Patient demographics, clinical outcome and support characteristics collected.
Fifty-one children were supported, 36 with the 70 cc TAH-t and 15 with the 50 cc TAH-t with a total support time of 6,243 days. The number of implants has increased with time (19 between 2015 and 2019). A total of 13 patients have been converted to Freedom Driver support, seven 50 cc TAH-t and six 70 cc TAH-t. The majority of implants in the last 5 years (15/19, 79%) have been with the 50 cc TAH-t. The most common diagnosis was dilated cardiomyopathy [24 (47%)] and the average age at the time of implant was 16±2 years old. Overall survival for the patient cohort was 71%.
The use of the SynCardia TAH-t to support children with end-stage heart failure has increased over time. Clinical outcomes with both the 50 cc and 70 cc TAH-t are similar to reported outcomes in adults who require TAH-t or other methods of biventricular support.
随着时间的推移，成人使用SynCardia临时全人工心脏（TAH-t）的情况有所增加。体积更小的50cc TAH-t的研发扩大了该设备在儿童中的潜在应用。我们试图描述TAH-t随时间的使用演变情况，并描述当前时代的治疗结果。
查询SynCardia数据库，以确定1985年12月至2019年10月期间植入该设备的所有18岁及以下儿科患者。收集患者的人口统计学资料、临床结果和支持特征。
51名儿童接受了支持，36名使用70cc TAH-t，15名使用50cc TAH-t，总支持时间为6243天。植入数量随时间增加（2015年至2019年期间为19例）。共有13名患者已转换为Freedom Driver支持，7名使用50cc TAH-t，6名使用70cc TAH-t。过去5年中的大多数植入（15/19，79%）使用的是50cc TAH-t。最常见的诊断是扩张型心肌病[24例（47%）]，植入时的平均年龄为16±2岁。患者队列的总体生存率为71%。
随着时间的推移，使用SynCardia TAH-t支持终末期心力衰竭儿童的情况有所增加。50cc和70cc TAH-t的临床结果与需要TAH-t或其他双心室支持方法的成人报告结果相似。
