TandemHeart device as rescue therapy in the management of acute heart failure

Heart Surg Forum. 2014 Jun;17(3):E160-2. doi: 10.1532/HSF98.2014348.

Abstract

Background: The TandemHeart device (THD) is a pump system that can be deployed percutaneously (PC) or via conventional surgical (CS) cannulation; it is capable of supporting one or both ventricles. It is a versatile system designed for use as a rescue device in acute heart failure and as a bridge to decision in moribund patients.

Methods: Retrospective analysis was conducted on all patients who underwent a THD implant; either PC or CS; at our institution. Univariate analysis was done using Fisher's exact and Chi-square tests for categorical variables and Wilcoxon Rank Sum test for continuous ones.

Results: 51 adult patients were identified: 10 PC and 41 CS. Mean age was 58.9 ± 12.8 years, and 31% were female. In hospital mortality was 61%. Univariate predictors of death were prolonged support (74% versus 46%, P = .04) and higher lactic acid levels (5.3 ± 4.9 versus 2.3 ± 1.9 mmol/L, P = .012). The length of stay (LOS) for survivors was 59.8 ± 30.0 days.

Conclusion: Uni- or bi-ventricular unloading can be successfully achieved using the THD, either trans-thoracically or percutaneously, with an acceptable complication profile.

MeSH terms

  • Causality
  • Comorbidity
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Heart Failure / mortality*
  • Heart Failure / prevention & control*
  • Heart-Assist Devices / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • New York / epidemiology
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Salvage Therapy / instrumentation
  • Salvage Therapy / mortality*
  • Salvage Therapy / statistics & numerical data
  • Shock, Cardiogenic / mortality*
  • Shock, Cardiogenic / prevention & control*
  • Survival Rate
  • Treatment Outcome