In keeping with its pioneering tradition of innovation in cardiovascular and transplant medicine, Stanford Hospital & Clinics is the first hospital in the Bay Area to offer patients with right or bi-ventricular heart failure a new option — the Syncardia Total Artificial Heart (TAH) — as a bridge to heart transplant.
Currently there is very strong option for patients with left ventricular failure, the Left Ventricular Assist Device or LVAD. But when the heart's right ventricle fails as well, there aren't as many good treatment options,says Richard Ha, MD, Surgical Director of Stanford's Mechanical Circulatory Support Program.
"With the addition of the total artificial heart, Stanford can address every type of end-stage heart failure," adds the program's medical director Dipanjan Banerjee, MD. The Syncardia heart has been used successfully in patients for more than one or two years. Plus, it comes with a portable battery, which allows patients to be out of the hospital while awaiting transplant.
Early intervention aids success
Implanting the total artificial heart is a very different procedure from implanting an LVAD, says Ha. With an LVAD implant, the patient's heart remains nearly intact.
But with the total artificial heart, surgeons remove almost the entire heart and replace it with the bio-prosthetic heart. Patients who receive the Syncardia heart tend to be sicker than the average assist device patient, says Ha. Thus, the operative and recovery times are longer.
The Stanford mechanical support team encourages providers to refer patients to the program early in the patient's care. Patients who are on an optimal medical regimen, but continue to fail despite these best efforts, should be referred to the program for evaluation. Worsening kidney function, more than one hospitalization for heart failure and intolerance with medications are all red flags, signs that a patient may need additional support for their heart, says Banerjee. "The longer we wait on these patients, the longer their recovery period and the worse candidate they are when they get to transplant."