SynCardia Total Artificial Heart Implant Procedures and Techniques

The SynCardia TAH replaces failing ventricles and provides circulatory support that allows recovery and ambulation. Right heart failure after LVAD implantation occurs in up to 37% of patients, with at least 7% requiring temporary or long-term right ventricular mechanical support. A subset of patients with advanced stage heart failure with fixed pulmonary hypertension and/or severe biventricular failure, or anatomic anomalies precluding LVAD implant, will require durable biventricular support with either an extracorporeal biventricular assist device (BiVAD) or a total artificial heart (TAH). SynCardia Temporary Total Artificial Heart is currently the only TAH system with European Conformity (CE Mark) and United States Food and Drug Administration approval for temporary support as a bridge to heart transplant. Although this system has been manufactured by different companies over the past 30 years, Symbion, CardioWest, and currently SynCardia, LLC, few changes have been made since the first clinical implantation in 1982. Few changes have been made in the implant procedure over the years and are described in detail in this chapter. Outcomes can be optimized with proper patient selection, early timing of implantation, quality patient care, and attentive device management.