Results with Syncardia Total Artificial Heart Beyond One Year

Mechanical circulatory support (MCS) devices have been increasingly used for long-term support. We reviewed outcomes in all patients supported with a SynCardia total artificial heart (TAH) for more than one year to assess its safety in long term support.As of December 2011 all 47 patients who received the TAH from 10 centres worldwide were included in this retrospective study. Clinical data was collected on survival, infections, thromboembolic and hemorrhagic events, device failures, and antithrombotic therapy.The mean age of patients was 50 ± 1.57 year, the median support time was 554 days (range 365 - 1373 days). The primary diagnosis was dilated cardiomiopathy in 23 patients, ischemic in 15 and "other" in 9.After a minimum of one year of support, 34 patients (72%) were successfully transplanted, 12 patients (24%) died while on device support, and 1 patient (2%) is still supported. Five patients (10%) had a device failure reported. Major complications were as follows: systemic infections in 25 patients (53%), drive line infections in 13 patients (27%), thromboembolic events in 9 patients (19%) and hemorrhagic events in 7 patients (14%).SynCardia TAH has proven to be a reliable and effective device in replacing the entire heart. In patients who reached a minimum of one year of support, device failure rate is acceptable and only in two cases was the leading cause of death. Infections and hemorrhagic events were the major causes of death. Patients who remain supported beyond one year are still likely to survive to transplantation.