Total Artificial Heart

Montefiore Einstein Center for Heart and Vascular Care physicians are now trained in implanting the SynCardia Total Artificial Heart, the first and only Food and Drug Administration–approved replacement heart for patients at risk of imminent death of heart failure. The SynCardia Total Artificial Heart is a lifesaving alternative that can serve as a bridge to a heart transplant for patients with end-stage heart disease.

A delegation led by Robert E. Michler, MD, Surgeon-in-Chief, Professor and Chairman, Cardiovascular and Thoracic Surgery, and Co-Director, Montefiore Einstein Center for Heart and Vascular Care at Montefiore Medical Center in New York City, traveled to the Texas Heart Institute at St. Luke’s Episcopal Hospital in Houston for a rigorous four-part training program. The team also included Daniel Goldstein, MD, lead implant surgeon and Surgical Director, Mechanical Support Program, and David A. D’Alessandro, MD, Surgical Director, Cardiac Transplantation Program, as well as anesthesiologists, perfusionists, critical care specialists and nurses.

“Developing this life-extending capability is a step forward for patients whose only option has been a heart transplant, which unfortunately is not always immediately available,” says Dr. Michler. “Patients with this Total Artificial Heart now have an alternative that extends their lives and improves their quality of life while they are waiting for a compatible donor heart.” Montefiore, which recently received the highest rating for quality in heart surgery programs by the Society of Thoracic Surgeons, is currently identifying heart failure patients who may be appropriate candidates for the Total Artificial Heart.

Similar to a donor heart, SynCardia’s Total Artificial Heart replaces both failing heart ventricles and the four heart valves, eliminating the symptoms and source of end-stage biventricular failure. However, unlike a donor heart, the Total Artificial Heart is immediately available for implantation, and patients do not require immunosuppressive drugs. Patients use a portable battery-powered driver in a case the size of a laptop computer to keep the artificial heart going. Previous artificial hearts had required patients to be tethered to large console-sized machines, limiting their mobility and quality of life, and keeping them in the hospital while awaiting a transplant. Other device benefits include:

• Among patients who received a Total Artificial Heart, the rate of survival to transplantation was 79 percent. Of the 35 control patients who met the same entry criteria but did not receive the artificial heart, only 46 percent survived to transplantation.
• Immediate, strong blood flow of up to 9.5 L/min through both ventricles, which helps vital organs recover more quickly.
• About 65 percent of Total Artificial Heart patients were out of bed by the fifth day after receiving the implanted device.
• Total Artificial Heart recipients were in better health than the control group when they received their donor heart transplants.

SynCardia-certified centers use a multidisciplinary approach to care. Members of the implant team represent several disciplines, including surgery, anesthesiology, perfusion, cardiology, critical care, hematology and transplant.