Three-month outcomes after the implantation of two HeartMate 3 devices in total artificial heart configuration

• Published in: Journal of cardiovascular surgery Vol. 64; no. 1; p. 121
• Main Authors: Dogan, Günes, Hanke, Jasmin S, Alhumood, Khaldoon, Tarazi, Riyad, Riebandt, Julia, Wiedemann, Dominik, Kneževič, Ivan, Haverich, Axel, Zimpfer, Daniel, Schmitto, Jan D
• Format: Journal Article
• Language: English
• Published: Italy 01.02.2023
• Subjects: Heart Failure - surgery; Heart Transplantation; Heart, Artificial - adverse effects; Heart-Assist Devices - adverse effects; Humans; Retrospective Studies
• ISSN: 1827-191X
• DOI: 10.23736/S0021-9509.22.12445-6

Total artificial heart (TAH) implantation is a rarely performed procedure. Contrarily, left ventricular assist device (VAD) implantation is rather common in many centers. As transplantation is quantitatively limited cardiac replacement with artificial hearts is a viable alternative in the treatment of severe biventricular heart failure. An alternative to TAH is the implantation of two VADs in a TAH configuration. We hereby present the first multi-center study on 3-months outcomes of patients treated by cardiectomy and placement of two HeartMate 3s in a TAH configuration. We retrospectively investigated a cohort of 15 patients that underwent HM3-TAH-implantation at three international institutions. Follow-up was 3 months after implantation. Baseline, intra- and postoperative parameters as well as survival data and adverse events were collected. A total of 1089 days on HM3-TAH were observed. Thirty-day survival after HM3-TAH implantation was 53% (8/15) and three month survival was 40% (6/15). The longest duration on device was 274 days. Causes of death were multi-organ failure, sepsis, and neurological adverse events. No technical complications were documented. Two patients remained on the device. Four patients (26%) were successfully bridged to transplantation. The implantation of two HeartMate 3s in a TAH configuration is a last resort and off-label concept in cases of extreme biventricular heart failure. In a diligently selected patient cohort, HM3-TAH implantation is a feasible method to increase the chance of survival in a severely ill patient cohort and successfully bridge patients to heart transplantation that would otherwise have died.