29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400098Turkish Soc Cardio

Balcıoğlu, Özlem

Engin, Ayşen Yaprak

Engin, Çağatay

Erkul, Sinan

Ertugay, Serkan

Nalbantgil, Sanem

Oğuz, Emrah

Yağdı, Tahir

Zoghi, Mehdi

Özbaran, Mustafa

Elsevier - Publisher Connector 

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SOP-099
The Use of Total Artiﬁcial Heart With Example of Cases for End-Stage Heart
Failure Therapy
Serkan Ertugay1, Özlem Balcıoglu1, Ays¸en Yaprak Engin1, Emrah Oguz1,
Çagatay Engin1, Mehdi Zoghi2, Sanem Nalbantgil2, Sinan Erkul1, Tahir Yagdı1,
Mustafa Özbaran1
1Ege University, Department of Cardiovascular Surgery, Izmir, 2Ege University,
Department of Cardiology, Izmir
Introduction: Ventricle Assist Device (VAD) implantation is an alternative treatment
for bridge-to-transplantation in heart failure therapy.Total Artiﬁcial Heart (TAH)
implantation is another branch of mechanical circulatory support (MCS).The main
advantage of this device is the possibility of both ventricular support.The current
indications for this therapy are biventricular failure, hypertrophic cardiomyopathy,
previous history of multiple mechanical valve replacement,malign arryhthmia
refractory to treatment, massive myocardial infarction with ventricular septal rupture.
In this study, our goal is to present the different examples of TAH implantation in
heart failure therapy.
Materials And Methods: Total Artiﬁcial Heart (SyncardiaCardiowest) consists of
two pump (70ml volume) running with pneumatic system and two vascular graft.
Implantation was performed with the excision of ventricle at the level of atrioven-
tricular valve. Vascular grafts was anastomosed to aorta and pulmonary artery. The
implantation of this device is limited to patients with body surface area greater than
1.7m2 and more than 12 cm sternal-spine distance. Case1: 58 years old, male, with the
diagnosis of idiopathic dilated cardiomyopathy, has been hospitalized for decom-
pansated heart failure. Patient showed signs of both left and right heart failure.
(LVEF20% RVEF:20%, TAPSE:9 mm on Echocardiography. Despite inotropic
support, patient developed cardiogenic shock. (INTERMACS level 1) TAH implan-
tation was performed emergently. Case 2: 40 years old male, with history of coronary
artery bypass and left ventricle aneurysmectomy, showed decompansation of heart
failure. Clinical ﬁndings and echocardiographic data showed biventricular heart
failure. (LVEF: 20%, RVEF 25%, TAPSE: 6mm) Despite inotropic support and IABP
implantation, patient had liver and renal failure. TAH was implanted urgently. Case 3:
Patient with the diagnosis of hypertrophic cardiomyopthy, was listed for heart
transplant. But patient developped an severe attack of malign ventricular arrhythmia
which requiring a battery change of ICD. Patient had decompansated heart failure.
Although he was at level of INTERMACS 4, TAH implantation was performed due to
arrhythmia.
Results: Three patient with different clinical picture of heart failure was treated
succesfully with TAH implantation. In all patients chest was kept open ﬁrst 3 days,
and than closed. One patient was reoperated for bleeding. One patient had an transient
ischemic attack without neurologic sequelae. Organ dysfunctions were completely
recovered in early postoperative period. All patients are discharged and monitored
outpatient without any symptoms of heart failure. D_ISCUSS_ION:The common
treatment for heart failure therapy with MCS, is LVAD implantation. TAH, which
recovers organ dysfunction with high and pulsatile blood ﬂow, is an important
alternative for heart transplant candiates with cardiogenic shock and other indications
before-mentioned.Electrophysiology–Ablation
Monday, October, 28, 2013, 10:15 AM-11:30 AM
Hall: SARAJEVO
Abstract nos: 100-105
OP-100
Atrial Fibrillation Node aBLAtion and Clinical ouTcomEs in Cardiac
Resynchronization Therapy (ABLATE-CRT) Trial
Serkan Çay1, Fatih Uçar1, Ahmet Duran Demir2, Göksel Çagırcı3,
Serkan Topaloglu1, Dursun Aras1, Sinan Aydogdu1
1Turkiye Yuksek Ihtisas Hospital, Ankara, 2Acibadem Hospital, Eskisehir, 3Antalya
Training and Research Hospital, Antalya
Background: Cardiac resynchronization therapy(CRT)is related with improved
morbidity and mortality in left bundle branch block(LBBB)with and without atrial
ﬁbrillation(AF). No clear data is present in non-LBBB with AF.
Methods: Patients with AF and CRT (LBBB and non-LBBB) requiring atrioven-
tricular node(AVN)ablation were assigned to AVN ablation and non-AVN ablation
groups. Primary end-points were composite of all-cause mortality or heart failure
hospitalization. Four-year follow-up was planned.
Results: A total of 82 patients with CRT were included. Of these, 38 (46%) had
LBBB with AF and 44 (54%) had non-LBBB with AF. Ablation was performed in 20JACC Vol 62/18/Suppl C j October 26–29, 2013 j TSC Abstracts/ORA(24%) patients with LBBB and in 22(27%) with non-LBBB. The mean age was 65
years. Males were 83%. Ischemic etiology was 51% and mean AF duration was 32
months. In all population the primary end-point of all cause mortality or heart failure
hospitalization was lower in AVN ablation patients compared with non-AVN ablation
patients (6.1% vs. 18.3%, p¼0.007), driven by reduction in both mortality (2.4% vs.
9.8%, p¼0.035) and hospitalization (6.1% vs. 15.9%, p¼0.024). In LBBB patients,
the primary end-point was also lower in AVN ablation patients compared with non-
AVN ablation patients (5.3% vs. 21.1%, p¼0.016), driven by reduction in both
mortality (0% vs. 10.5%, p¼0.026) and hospitalization (5.3% vs. 18.4%, p¼0.036). In
non-LBBB patients, the primary end-point was 6.8% and 15.9% in AVN ablation
group and non-AVN ablation group, respectively.However,this difference did not
reach a statistical signiﬁcance (p¼0.150) (Figure).
Conclusion: The morbidity and mortality beneﬁt of AVN ablation was demonstrated
in heterogeneous group of patients with or without LBBB and AF.Subgroup analysis
of patients with non-LBBB and AF did not, however, show the same beneﬁt.OP-101
Cryoablation First theRapy OutcomeS compared to after-drug Therapy (C-
Frost) Trial
Dursun Aras1, Serkan Topaloglu1, Serkan Çay1, Fırat Özcan1, Fatih Uçar1,
Özcan Özeke1, Osman Turak1, Göksel Çagırcı2
1Turkiye Yuksek Ihtisas Hospital, Ankara, 2Antalya Training Hospital, Antalya
Background: Cryoballoon ablation of atrial ﬁbrillation (AF) is an effective therapy in
maintaining sinus rhythm. The procedure is mainly recommended for anti-arrhythmic
resistant cases. No randomized study is, however, present about cryoablation as ﬁrst
line therapy.
Aim: The aim is to compare cryoablation as ﬁrst line therapy with cryoablation after
drug resistance.
Methods: Consecutive patients (all-comers) with paroxysmal AF (PAF) planned for
catheter ablation were randomized to cryoballoon (Arctic Front Advance, Medtronic)
ablation as ﬁrst-line therapy without prior anti-arrhythmic drug use (n¼33) and cry-
oballoon (Arctic Front Advance, Medtronic) ablation after at least one anti-arrhythmic
drug resistance (n¼23). All patients were followed-up at least 12 months. Periodic
ambulatory Holter monitoring was performed to detect any recurrence at 1, 3, 6, 9, 12,
and every 6 months after 1 year.
Results: The median age was 49 years. Male was 66% and 7% of patients had dia-
betes and 34% had hypertension. The mean follow-up period was 185 months and
the mean procedural time was 598 minutes. The primary end-point of freedom from
AF was found to be statistically indifferent in both groups (78.8% for ﬁrst-line therapy
vs. 78.3% for after-drug therapy, p¼0.857) (ﬁgure).
Conclusion: Cryoballoon ablation as ﬁrst-line therapy is as effective as cryoballoon
ablation after anti-arrhythmic drug resistance in maintaining sinus rhythm.LS C45


The Use of Total Artificial Heart With Example of Cases for End-Stage Heart Failure Therapy 

WOS: 00032985840009829th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYTurkish Soc Cardio

Balcioglu, Ozlem

Engin, Aysen Yaprak

Oguz, Emrah

Engin, Cagatay

Yagdi, Tahir

Ozbaran, Mustafa

Ege University Institutional Repository

Journal of the American College of Cardiology

The Use of Total Artificial Heart With Example of Cases for End-Stage Heart Failure Therapy

Erkul, SİNAN

ÖZBARAN, MUSTAFA

YAĞDI, TAHİR

NALBANTGİL, SANEM

ZOGHİ, MEHDİ

ENGİN, ÇAĞATAY

ERTUGAY, SERKAN

OĞUZ, EMRAH

Kütahya Health Sciences University Research Information System

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The Use of Total Artificial Heart With Example of Cases for End-Stage Heart Failure Therapy

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