Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart



      Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH).


      We studied 66 consecutive patients implanted with the TAH at our institution from 2006 through 2012 and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes.


      Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively. INTERMACS profile 1 patients had decreased 6-month survival on the device compared with those in profiles 2–4 (74% vs 95%, log rank: P = .015). For the 50 patients surviving to heart transplantation, the 1-year posttransplant survival was 82%. There was no difference in 1-year survival when comparing patients in the INTERMACS 1 profile with less severe profiles (79% vs 84%; log rank test P = .7; hazard ratio [confidence interval] 1.3 [0.3–4.8]).


      Patients implanted with the TAH as INTERMACS profile 1 had reduced survival to transplantation compared with less sick profiles. INTERMACS profile at the time of TAH implantation did not affect 1-year survival after heart transplantation.

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        • Kirklin J.K.
        • Naftel D.C.
        • Pagani F.D.
        • Kormos R.L.
        • Stevenson L.W.
        • Blume E.D.
        • et al.
        Sixth INTERMACS annual report: a 10,000-patient database.
        J Heart Lung Transplant. 2014; 33: 555-564
        • Boyle A.J.
        • Ascheim D.D.
        • Russo M.J.
        • Kormos R.L.
        • John R.
        • Naka Y.
        • et al.
        Clinical outcomes for continuous-flow left ventricular assist device patients stratified by pre-operative INTERMACS classification.
        J Heart Lung Transplant. 2011; 30: 402-407
        • Alba A.C.
        • Rao V.
        • Ivanov J.
        • Ross H.J.
        • Delgado D.H.
        Usefulness of the INTERMACS scale to predict outcomes after mechanical assist device implantation.
        J Heart Lung Transplant. 2009; 28: 827-833
        • Yoshioka D.
        • Sakaguchi T.
        • Saito S.
        • Miyagawa S.
        • Nishi H.
        • Yoshikawa Y.
        • et al.
        Predictor of early mortality for severe heart failure patients with left ventricular assist device implantation: significance of INTERMACS level and renal function.
        Circ J. 2012; 76: 1631-1638
        • Copeland J.G.
        • Copeland H.
        • Gustafson M.
        • Mineburg N.
        • Covington D.
        • Smith R.G.
        • et al.
        Experience with more than 100 total artificial heart implants.
        J Thorac Cardiovasc Surg. 2012; 143: 727-734
        • Shah K.B.
        • Tang D.G.
        • Kasirajan V.
        • Gunnerson K.J.
        • Hess M.L.
        • Sica D.A.
        Impact of low-dose B-type natriuretic peptide infusion on urine output after total artificial heart implantation.
        J Heart Lung Transplant. 2012; 31: 670-672
        • Shah K.B.
        • Kalya A.V.
        • Hassanein M.T.
        • Tang D.G.
        • Arabia F.A.
        • Kasirajan V.
        Infusion of Nesiritide after Implantation of the Total Artificial Heart Is Associated with Decreased Need for Kidney Transplantation.
        J Heart Lung Transplant. 2014; 33: S61
        • Stevenson L.W.
        • Pagani F.D.
        • Young J.B.
        • Jessup M.
        • Miller L.
        • Kormos R.L.
        • et al.
        INTERMACS profiles of advanced heart failure: the current picture.
        J Heart Lung Transplant. 2009; 28: 535-541
        • Mankad A.K.
        • Tang D.G.
        • Clark W.B.
        • Flattery M.
        • Harton S.
        • Katlaps G.J.
        • et al.
        Persistent anemia after implantation of the total artificial heart.
        J Card Fail. 2012; 18: 433-438
        • Shah K.B.
        • Volman R.A.
        • Harton S.
        • Tang D.G.
        • Kasirajan V.
        Fracture of the total artificial heart pneumatic driveline after transition to the portable driver.
        J Heart Lung Transplant. 2013; 32: 1041-1043
        • Krabatsch T.
        • Potapov E.
        • Stepanenko A.
        • Schweiger M.
        • Kukucka M.
        • Huebler M.
        • et al.
        Biventricular circulatory support with two miniaturized implantable assist devices.
        Circulation. 2011; 124: S179-86
        • Cleveland Jr, J.C.
        • Naftel D.C.
        • Reece T.B.
        • Murray M.
        • Antaki J.
        • Pagani F.D.
        • et al.
        Survival after biventricular assist device implantation: an analysis of the Interagency Registry for Mechanically Assisted Circulatory Support database.
        J Heart Lung Transplant. 2011; 30: 862-869
        • Cheng R.K.
        • Deng M.C.
        • Tseng C.
        • Shemin R.J.
        • Kubak B.M.
        • MacLellan W.R.
        Risk stratification in patients with advanced heart failure requiring biventricular assist device support as a bridge to cardiac transplantation.
        J Heart Lung Transplant. 2012; 31: 831-838
        • Nguyen A.
        • Pozzi M.
        • Mastroianni C.
        • Léger P.
        • Loisance D.
        • Pavie A.
        • et al.
        Bridge to transplantation using paracorporeal biventricular assist devices or the syncardia temporary total artificial heart: is there a difference?.
        J Cardiovasc Surg (Torino). 2015; 56: 493-502
        • Kirsch M.
        • Mazzucotelli J.-P.
        • Roussel J.-C.
        • Bouchot O.
        • N'loga J.
        • Leprince P.
        • et al.
        Survival after biventricular mechanical circulatory support: does the type of device matter?.
        J Heart Lung Transplant. 2012; 31: 501-508
        • Lund L.H.
        • Edwards L.B.
        • Kucheryavaya A.Y.
        • Dipchand A.I.
        • Benden C.
        • Christie J.D.
        • et al.
        The Registry of the International Society for Heart and Lung Transplantation: thirtieth official adult heart transplant report–2013.
        J Heart Lung Transplant. 2013; 32: 951-964