Razumov Artyom, Burri Melchior, Zittermann Armin, Radakovic Darko, Lauenroth Volker, Rojas Sebastian V, Fox Henrik, Schramm René, Gummert Jan, Deutsch Marcus-André, Morshuis Michiel
Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
Department of Cardiovascular Surgery, German Heart Centre Munich, Technical University of Munich, Munich, Germany.
Artif Organs. 2025 Feb;49(2):266-275. doi: 10.1111/aor.14860. Epub 2024 Sep 16.
The SynCardia® temporary total artificial heart (TAH) serves as a mechanical circulatory support device for patients suffering from irreversible biventricular failure.
This retrospective study analyzed 196 consecutive patients who underwent TAH implantation at our center from 2001 to 2021. We assessed survival rates and all-cause mortality during TAH support, including survival post-heart transplantation.
The median age of patients was 55 years, with 88% being male. The primary diagnoses included cardiomyopathy (43.9%), acute myocardial infarction (26.5%), and postcardiotomy heart failure (15.5%). At implantation, 87.2% of patients were classified as INTERMACS Profile 1. The median duration of support was 96 days (IQR: 23-227). Survival rates at 1, 6, and 12 months were 72%, 41%, and 34%, respectively. Postoperative rethoracotomy was necessary in 44.4% of patients; 39.3% experienced neurological events and 24.6% developed gastrointestinal bleeding. Overall, 64.8% of patients died while on support, primarily due to multiple organ failure (55.9%). Factors such as older age, higher bilirubin levels, postcardiotomy and specific underlying diagnoses were independent predictors of mortality during TAH support. On a positive note, 35.2% of patients underwent successful heart transplants, with 1-, 5-, and 10-year posttransplant survival rates of 65%, 58%, and 51%, respectively.
While high mortality rates persist among patients with biventricular failure, the SynCardia® TAH offers a viable interim solution for critically ill patients, particularly those who can be successfully bridged to heart transplantation.
SynCardia®临时全人工心脏（TAH）作为一种机械循环支持装置，用于治疗患有不可逆双心室衰竭的患者。
这项回顾性研究分析了2001年至2021年在我们中心接受TAH植入的196例连续患者。我们评估了TAH支持期间的生存率和全因死亡率，包括心脏移植后的生存率。
患者的中位年龄为55岁，88%为男性。主要诊断包括心肌病（43.9%）、急性心肌梗死（26.5%）和心脏术后心力衰竭（15.5%）。植入时，87.2%的患者被归类为INTERMACS Profile 1。中位支持时间为96天（四分位间距：23 - 227天）。1个月、6个月和12个月时的生存率分别为72%、41%和34%。44.4%的患者需要术后再次开胸；39.3%的患者发生神经系统事件，24.6%的患者出现胃肠道出血。总体而言，64.8%的患者在支持期间死亡，主要原因是多器官功能衰竭（55.9%）。年龄较大、胆红素水平较高、心脏术后以及特定的潜在诊断等因素是TAH支持期间死亡率的独立预测因素。值得注意的是，35.2%的患者成功接受了心脏移植，移植后1年、5年和10年的生存率分别为65%、58%和51%。
虽然双心室衰竭患者的死亡率仍然很高，但SynCardia® TAH为重症患者提供了一种可行的临时解决方案，特别是那些能够成功过渡到心脏移植的患者。
