- 作者：K.B. Shah1 ; R.A. Volman1 ; S.C. Harton1 ; D.G. Tang2 ; V. Kasirajan2
- 刊名：The Journal of Heart and Lung Transplantation
- 出版年：2013
- 出版时间：April, 2013
- 年：2013
- 卷：32
- 期：4_supp_S
- 页码：S54
- 全文大小：229 K
Purpose
With the introduction of portable drivers (PD), patients (pts) with the total artificial heart (TAH) no longer are required to remain tethered to a massive in-hospital driver (IHD). With increased mobility pts may introduce torque and stress the pneumatic drivelines. We examined the incidence of driveline fracture (Fx) in pts on PD.Methods and Materials
We conducted a single-center retrospective study of consecutive pts who received a TAH (2006-2012). Baseline characteristics and laboratory data were compared with a chi-squares and independent t-tests.
Results
Sixty-six pts were implanted with the TAH and 16(24 % ) were converted to PD. Pts on both drivers were of similar age and body surface area, however PD pts were on support for a longer duration of time (median[range]:216[73-694] vs 75[1-379], P<0.001). Five pts (8 % ) experienced Fx of the driveline requiring repair. Two pts reported fault alarms from the driver, the other 3 noticed a hissing sound from the Fx. All Fxs occurred in pts after transfer to the PD while no pts who stayed on the IHD experienced a driveline fracture (31 % vs. 0 % , P<0.001). The pts who suffered a Fx had longer times on TAH support (483[271-694] vs 89[1-460], P<0.001,) and 5/7 pts on device >9 months required repair. [] The Fx was repaired with mechanical excision in 2 pts and covered with vulcanizing tape in the remaining 3. None of the Fx resulted in death.
Conclusions
Fx of the pneumatic TAH driveline was observed only in pts converted to the PD. Factors contributing to this potentially fatal complication include increased duration on TAH support and mechanical stress from increased activity and mobility. Durability of the TAH driveline may limit successful long-term support with the device.