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Original Articles: Adult Cardiac

CardioWest (Jarvik) Total Artificial Heart: A Single-Center Experience With 42 Patients

^a Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, Nantes Hospital University, Nantes, France
^c Department of Cardiology, Institut du Thorax, Nantes Hospital University, Nantes, France
^b Thoracic Transplantation Unit, Institut du Thorax, Nantes Hospital University, Nantes, France

Accepted for publication September 23, 2008.

^_* Address correspondence to Dr Roussel, Chirurgie Thoracique et Cardio-Vasculaire, Institut du Thorax, Boulevard Jacques Monod–Saint Herblain, Nantes Cédex 1, 44 093, France (Email: jeanchristian.roussel{at}chu-nantes.fr).

Presented at the Forty-fourth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2008.

Background: When implanted in patients with biventricular failure, the CardioWest total artificial heart has asserted itself over time as a reliable bridge-to-transplant device that as yet is used by only a few international teams. The aim of this single-center retrospective study is to assess both the comorbidity and survival of patients awaiting heart transplants while receiving circulatory support with a CardioWest total artificial heart.

Methods: From 1990 to December 2006, 42 patients received a CardioWest total artificial heart at our center. Mean age at the time of implantation was 45.7 ± 9.5 years, and 40 patients (95%) were men. Idiopathic or dilated cardiomyopathy was diagnosed in 45.2% (n = 19) of the patients and ischemic cardiomyopathy in 42.8% (n = 18). Average body surface area was 1.9 ± 0.22 m².

Results: Duration of support was 1 to 292 days (mean, 101 ± 86 days). Twelve patients died (28.5%) while receiving device support, and 30 patients (71.5%) underwent transplantation. Actuarial survival rates for the transplanted patients were 90% (n = 25), 81% (n = 14), and 76% (n = 10) at 1, 5, and 10 years, respectively. Causes of death during device support included multiorgan failure in 6 (50%), sepsis in 2, acute respiratory distress syndrome in 2, alveolar hemorrhage in 1, and other cause in 1. There were no device malfunctions that led to patient death. Adverse events included stroke in 3 patients (7%) and infections in 35 patients (85%) during support.

Conclusions: The CardioWest total artificial heart is an excellent bridge-to-transplant device for patients with biventricular failure. Our study demonstrates excellent safety, reliability, and efficiency. Exceptional outcome after transplantation underlines its capacity to aid in end-organ recovery.