Patients With a Body Surface Area Less Than 1.7 m2 Have a Good Outcome With the CardioWest Total Artificial Heart

Pascal Leprince; Nicolas Bonnet; Shaida Varnous; Actar Rama; Philippe Léger; Alexandre Ouattara; Marc Landi; Jacques Szefner; Iradj Gandjbakhch; Alain Pavie

doi:10.1016/j.healun.2005.01.016

Mechanical circulatory support| Volume 24, ISSUE 10, P1501-1505, October 2005

Patients With a Body Surface Area Less Than 1.7 m² Have a Good Outcome With the CardioWest Total Artificial Heart

Pascal Leprince, MD
Pascal Leprince
Correspondence
Reprint requests: Pascal Leprince, MD, Service de chirurgie Thoracique et Cardiovasculaire, Institut du cœur, 47-83 Bd de l’hôpital, 75013 Paris, France. Telephone: 33 1 42 16 56 32. Fax: 33 1 42 16 56 29.
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Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Nicolas Bonnet, MD
Nicolas Bonnet
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Shaida Varnous, MD
Shaida Varnous
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Actar Rama, MD
Actar Rama
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Philippe Léger, MD
Philippe Léger
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Alexandre Ouattara, MD
Alexandre Ouattara
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Marc Landi, MD
Marc Landi
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Jacques Szefner
Jacques Szefner
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Iradj Gandjbakhch, MD
Iradj Gandjbakhch
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Alain Pavie, MD
Alain Pavie
Affiliations
Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, Paris, France.
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Published:May 09, 2005DOI:https://doi.org/10.1016/j.healun.2005.01.016

Background

A body surface area (BSA) of 1.7 m² was considered as the lower limit to implant a CardioWest Total Artificial Heart (TAH). We reviewed our experience with the TAH in patients with a BSA of less than 1.7 m².

Methods

From April 1986 to May 2003, among 149 patients implanted with a TAH in our institution, 30 had a BSA of less than 1.7 m² (Group I). Results were compared with the remaining 119 patients (Group II).

Results

One patient in Group I experienced a fitting problem and was left with the chest open. Otherwise, in this group, the Day 1 cardiac index averaged 3.6 ± 0.6 liter/min/m², which was significantly higher than the 2.8 ± 0.36 liter/min/m² observed in Group II. Post-implantation central venous pressure and mean arterial pressure were similar in both groups: 14.7 ± 3.8 mm Hg vs 14.5 ± 4 mm Hg and 87 ± 23 mm Hg vs 88 ± 19 mm Hg, respectively. In Group I, survival on the device dramatically increased from 9% before 1992, to 36% between 1992 and 1997 and finally reached 75% after then. In the meantime, for the same time periods, global survival to hospital discharge increased from 9% to 36% and reached 50% after 1997. In Group II, global survival to hospital discharge was 25.5% before 1992, 34.6% between 1993 and 1997, and reached 52% thereafter.

Conclusion

The CardioWest TAH can be used in patients with a BSA between 1.5 m² and 1.7 m² with few fitting problems. In this group of patients, results are similar to those obtained in patients with a BSA greater than 1.8 m².

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Article info

Publication history

Published online: May 09, 2005

Accepted: January 12, 2005

Received in revised form: December 23, 2004

Received: June 28, 2004

Identification

DOI: https://doi.org/10.1016/j.healun.2005.01.016

Copyright

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