Arizona experience with CardioWest Total Artificial Heart bridge to transplantation

Background. We hypothesized that bridge to transplantation with the CardioW est Total Artificial Heart would succeed in a large percentage of patients. Further, we hypothesized that this success rate would not be significantly decreased by infection or thromboembolism. Methods. From 1993 to March 1999, 24 patients received implants with the in tention of bridge to transplantation. Data were collected prospectively. He parin, coumadin, aspirin, ticlopidine, dipyridamole, and pentoxifylline wer e used for anticoagulation. Results. Four patients died while on device support. Nineteen of 23 patient s (83%) were transplanted. All 19 survived long term. One patient remains o n CardioWest Total Artificial Heart support 6 weeks after implant. There wa s one stroke on the day of transplantation. There was a second stroke on th e day of implantation. Neither stroke caused significant residual deficits. Both were in close relationship to an operative procedure. There were no s erious device-related infections. Conclusions. The CardioWest Total Artificial Heart salvaged 20 of 24 critic ally ill patients. Neither infections nor neurologic problems were signific ant. We believe it is the device of choice for decompensating patients with biventricular failure who have adequate body and heart size. (C) 1999 by T he Society of Thoracic Surgeons.