Home discharge and out-of-hospital follow-up of total artificial heart patients supported by a portable driver system

Aly El Banayosy, Lukacz Kizner, Latif Arusoglu, Michael Morshuis, Christof Brehm, Reiner Koerfer, Christoph Schuermann, Richard G. Smith, Jack G. Copeland, Marvin J. Slepian

Research output: Contribution to journalArticle

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Abstract

To enhance ambulation and facilitate hospital discharge of total artificial heart (TAH)-supported patients, we adapted a mobile ventricular assistance device (VAD) driver (Excor) for TAH use and report on the performance of Excor-driven TAH patients discharged home. Ten patients stabilized on a TAH, driven by the CSS ("Circulatory Support System"), were progressively switched over to the Excor in hospital over 14 days as a pilot, with daily hemodynamics and laboratory parameters measured. Twenty-two stable TAH patients were subsequently placed on the Excor, trained, and discharged home. Clinical and hemodynamic parameters were followed. All pilot study patients were clinically stable on the Excor, with no decrease in TAH output noted (6.3 + 0.3 L/min [day 1] vs. 5.8 + 0.2 L/min [day 14], p = 0.174), with a trend suggesting improvement of both hepatic and renal function. Twenty-two TAH patients were subsequently successfully discharged home on the portable driver and were supported out of hospital for up to 598 days (range, 2-598; mean = 179 ± 140 days), remaining ambulatory, New York Heart Association (NYHA) class I or II, and free of readmission for 88.5% of the time of support. TAH patients may be effectively and safely supported by a mobile drive system. As such, the utility of the TAH may be extended to support patients beyond the hospital, at home, with overall ambulatory freedom.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalASAIO Journal
Volume60
Issue number2
DOIs
StatePublished - 2014

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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    El Banayosy, A., Kizner, L., Arusoglu, L., Morshuis, M., Brehm, C., Koerfer, R., Schuermann, C., Smith, R. G., Copeland, J. G., & Slepian, M. J. (2014). Home discharge and out-of-hospital follow-up of total artificial heart patients supported by a portable driver system. ASAIO Journal, 60(2), 148-153. https://doi.org/10.1097/MAT.0000000000000046