Home Discharge and Out-of-Hospital Follow-Up of Total Artificial Heart Patients Supported by a Portable Driver
A. El Banayosy, M. Morshius, M. Slepian, L. Arusoglu, J. Gummert. Heart and Vascular Institute, Penn State Hershey Medical Center, Hershey, PA; Cardiology, University of Arizona, Tucson, AZ; Cardiac Surgery, Heart Center NRW, Bad Oeynhausen, Germany
Purpose: To enhance ambulation and facilitate hospital discharge of TAH-supported patients we adapted a mobile ventricular assistance device (VAD) driver (ExcorTM) for TAH use and report on the performance of ExcorTM– driven TAH patients discharged home.
Methods and Materials: Ten patients stabilized on a TAH, driven by the CSS, were progressively switched over to the ExcorTM in hospital over 14 days as a pilot, with daily hemodynamics and lab parameters measured. Twenty-two stable TAH patients were subsequently placed on the ExcorTM, trained and discharged home. Clinical and hemodynamic parameters were followed.
Results: All pilot study patients were clinically stable on the ExcorTM, 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, NYHA Class I or II, and free of readmission for 88.5% of the time of support.
Conclusions: 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.
Session: Poster Session 3: Mechanical Circulatory Support (9:00 AM-6:30 PM)
Date/Time: Friday, April 26, 2013 - 5:30 PM