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Late Surgical Bleeding Following Total Artificial Heart Implantation
Author(s) -
Hermsen Joshua L.,
Smith Jason W.,
Pal Jay D.,
Mahr Claudius,
Masri S. Carolina,
Dardas Todd F.,
Cheng Richard K.,
Mokadam Nahush A.
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12601
Subject(s) - medicine , tamponade , surgery , cardiac tamponade , cardiopulmonary bypass , implant , artificial heart , anastomosis , pseudoaneurysm , heart failure , ventricular assist device , cardiac output , fibrous joint , cardiac surgery , hemodynamics , cardiology , complication
A bstract Introduction Mechanical circulatory support for heart failure, including the Total Artificial Heart (TAH, Syncardia, Tucson, AZ, USA) has increased in recent years. This report describes bleeding complications associated with the device. Methods A single institution prospectively maintained quality improvement database was reviewed encompassing the first year of clinical experience with the TAH. Patients who underwent TAH implantation were identified, and a review of complications and outcomes was undertaken. Results Ten patients underwent TAH implant. Four patients experienced delayed postoperative bleeding. In three patients the manifestation of bleeding was tamponade and evidenced by TAH decreased cardiac output. In two patients, at postoperative days 31 and 137, there was a partial disruption of the aortic anastomosis along the outer curvature with pseudoaneurysm formation. Both were repaired by primary suture closure, without use of cardiopulmonary bypass. There was no mortality attributable to bleeding. Conclusions TAH patients are at risk for delayed postoperative bleeding, often manifest as an acute decrease in cardiac output. Due to pulsatility and high dP/dT, bleeding from the aortic anastomosis should be considered in the differential of a patient with low flow and/or tamponade. doi: 10.1111/jocs.12601 (J Card Surg 2015;30:771–774)