Heart Substitution: Transplantation and Total Artificial Heart. The Texas Heart Institute Experience

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Abstract
Two methods of heart substitution were used at the Texas Heart Institute [Texas, USA]; cardiac transplantation and the total artificial heart (TAH). Cardiac transplantation is an effective means of saving patients with endstage heart disease and, since the introduction of the immunosuppressive agent cyclosporine, survival has increased significantly. In a recent series from July 1982-May 1984, 25 patients underwent cardiac transplantation at the Texas Heart Institute. Nineteen are alive, in Functional Class I, and leading normal lives. A major disadvantage of cardiac transplantation is that it cannot be used on an emergency basis for postcardiotomy patients. In this situation, TAH was used twice (1969 and 1981) as the 1st stage to maintain circulation prior to subsequent cardiac transplantation. In both instances, the TAH functioned well until a satisfactory donor was found. This demonstrates the feasibility of the 2-staged concept and encourages further development of cardiac prostheses.

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