(425) - The Worldwide Experience of SynCardia Total Artificial Heart in Patients with Congenital Heart Disease

Abstract

Over the past 3 decades, increasingly successful palliation of children with congenital heart disease (CHD) has created an ever increasing cohort of adolescents and adults with congenital heart disease. A proportion of these patients develop heart failure and fail medical management necessitating mechanical circulatory support. Biventricular failure, residual lesions, and intractable arrhythmias are often encountered in this cohort making cardiac replacement by the SynCardia total artificial heart (TAH) a reasonable option. We aim to describe the worldwide use of TAH in the CHD cohort since its inception. All CHD patients who had SynCardia TAH implanted from 1986 to 2014 were identified in Worldwide SynCardia TAH database which has 1398 patients as of December 31, 2014. TAH was implanted in 47 (3.4%) patients with CHD in 31 institutions around the world. There is an increase in number of devices/year since 2011 [Figure]. Median age was 21yo (9-56) with 17% (8) ≤18 yo and 20% (11) were female. Total days of support were 10731 days with a median of 46 (0-500). Overall survival was 53% with 88% survival in adolescents with CHD. Only 19% (9) required support over 6 months. Since the approval of Freedom Driver in 2010, 28% (8/29) cases have used it, all of whom survived. One-month conditional survival was 76% (19/25); alive or transplanted. [Table] There has been a notable increase in the use of SynCardia TAH in CHD patients. Although a challenging cohort, the majority of these complex patients were successfully supported, particularly adolescents with CHD.View Large Image Figure ViewerDownload Hi-res image Download (PPT)