Palavras-chave
Heart failure
Mechanical circulatory support
Cardiac transplantation
Como Citar
Resumo
Heart failure (HF) is a complex clinical syndrome characterized by symptoms such as dyspnea, edema, and fatigue, resulting from structural or functional abnormalities of the heart. Despite advances in clinical and surgical treatment, mortality remains high, especially in end-stage cases. In this context, artificial hearts have emerged as a promising therapeutic alternative. Since the first human implant in 1960, these devices have significantly evolved, incorporating intelligent sensors and biocompatible materials that enhance their functionality and safety. This study aimed to analyze the role of artificial hearts, with a focus on the Total Artificial Heart (TAH), as a therapeutic resource for advanced heart failure, highlighting their clinical benefits, limitations, and practical implications. The methodology consisted of an integrative literature review with a qualitative approach. The databases used were LILACS, MEDLINE/PubMed, and SciELO. Inclusion criteria involved publications from the last five years, with full texts and review methodologies. The selection process included title and abstract screening followed by full-text reading of eligible studies. In total, 12 articles were included in the analysis. The results demonstrated that TAH represents a viable alternative to cardiac transplantation, especially given the shortage of donors. Studies showed improved survival rates, acceptable postoperative adaptation, and effective hemodynamic control with next-generation devices. However, complication and mortality rates remain significant, making careful patient selection and multidisciplinary team preparation essential. TAH has been consolidated both as a bridge to transplantation and as destination therapy in specific cases. In conclusion, artificial hearts represent a significant advancement in the treatment of terminal heart failure, providing expanded therapeutic options and improving the quality of life for affected patients.
Referências
ARABÍA, F. A.; MURRAY, C. F. The total artificial heart: where have we been, where are we now, where are we going? Indian journal of thoracic and cardiovascular surgery, v. 39, n. Suppl 1, p. 198–205, 2023. Disponível em: https://doi.org/10.1007/s12055-023-01559-8. Acesso em: 29 jun. 2025.
BRIASOULIS, A. et al. Trends in utilization, mortality, major complications, and cost after total artificial heart implantation in the United States (2009-2015). Hellenic Journal of Cardiology, v. 61, n. 6, p. 407–412, 2020. Disponível em: https://doi.org/10.1016/j.hjc.2019.02.002. Acesso em: 29 jun. 2025.
BURGOS, L. M. et al. Evaluación de signos vitales mediante una aplicación móvil en pacientes con insuficiencia cardiaca: ¿una oportunidad para la titulación remota? Archivos de cardiología de México, v. 94, n. 1, p. 86-94, 2024. Disponível em: https://doi.org/10.24875/acm.22000221. Acesso em: 29 jun. 2025.
CARVALHO, W. N. DE et al. Potentially inappropriate cardioverter defibrillator implants in secondary prevention of death. Arquivos brasileiros de cardiologia, v. 121, n. 10, p. e20220899, 2024. Disponível em: https://doi.org/10.36660/abc.20220899. Acesso em: 29 jun. 2025.
CHUNG, J. S. et al. Total artificial heart: surgical technique in the patient with normal cardiac anatomy. Annals of Cardiothoracic Surgery, v. 9, n. 2, p. 81–88, 2020. Disponível em: https://doi.org/10.21037/acs.2020.02.09. Acesso em: 29 jun. 2025.
CREVELARI, E. S. et al. Efficacy, safety, and performance of isolated left vs. Right ventricular pacing in patients with bradyarrhythmias: A randomized controlled trial. Arquivos brasileiros de cardiologia, v. 112, n. 4, p. 410–421, 2019. Disponível em: https://doi.org/10.5935/abc.20180275. Acesso em: 29 jun. 2025.
EIDELMAN, G. et al. Resultados del primer registro de implante de cardiodesfibriladores y resincronizadores SAC (RENCARE). Revista Argentina de Cardiologia, v. 88, n. 5, p. 429–433, 2020. Disponível em: https://dx.doi.org/10.7775/rac.es.v88.i5.18798. Acesso em: 19 jun. 2025.
FORNO, A. R. J. D. et al. Estimulação do Ramo Esquerdo do Sistema His-Purkinje: Experiência Inicial. Arquivos Brasileiros de Cardiologia, v. 118, n. 2, p. 505–516, 2022. Disponível em: https://doi.org/10.36660/abc.20201085. Acesso em: 29 jun. 2025.
FUMARULO, I. et al. Cardiac replacement therapy: Critical issues and future perspectives of heart transplantation and artificial heart. Current Problems in Cardiology, v. 50, n. 3, p. 102971, 2025. Disponível em: https://doi.org/10.1016/j.cpcardiol.2024.102971. Acesso em: 29 jun. 2025.
HUENGES, K. et al. Case report—CARMAT: the first experience with the Aeson bioprosthetic total artificial heart as a bridge to transplantation in a case of post-infarction ventricular septal rupture. Frontiers in Cardiovascular Medicine, v. 10, p. 1211365, 2023. Disponível em: https://doi.org/10.3389/fcvm.2023.1211365. Acesso em: 29 jun. 2025.
JIMENO-SAN MARTÍN, L. et al. Postoperative management and nursing care after implantation of a total artificial heart: Scoping review. Enfermería Intensiva (English ed ), v. 35, n. 3, p. 213–228, 2024. Disponível em: https://doi.org/10.1016/j.enfie.2023.08.006. Acesso em: 29 jun. 2025.
KARIMOV, J. H. et al. Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working model. JTCVS techniques, v. 28, p. 124–131, 2024. Disponível em: https://doi.org/10.1016/j.xjtc.2024.09.001. Acesso em: 29 jun. 2025.
KURODA, T. et al. Biventricular assist devices and total artificial heart: Strategies and outcomes. Frontiers in Cardiovascular Medicine, v. 9, p. 972132, 2022. Disponível em: https://doi.org/10.3389/fcvm.2022.972132. Acesso em: 29 jun. 2025.
LEE, J.; OH, J.; KANG, S.-M. Another, A few good device for end stage heart failure. International journal of heart failure, v. 6, n. 2, p. 82–83, 2024. Disponível em: https://doi.org/10.36628/ijhf.2024.0023. Acesso em: 29 jun. 2025.
LINDENMUTH, D. M. et al. Enhanced Recovery After Surgery in Patients Implanted with Left Ventricular Assist Device. Journal of Cardiac Failure, v. 27, n. 11, p. 1195–1202, 2021. Disponível em: https://doi.org/10.1016/j.cardfail.2021.05.006. Acesso em: 29 jun. 2025.
MALAS, J. et al. Experience With SynCardia Total Artificial Heart as a Bridge to Transplantation in 100 Patients. The Annals of Thoracic Surgery, v. 115, n. 3, p. 725–732, 2023. Disponível em: https://doi.org/10.1016/j.athoracsur.2022.11.034. Acesso em: 29 jun. 2025.
MCDONAGH, T. A. et al. 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. European Heart Journal, v. 42, n. 36, p. 3599–3726, 2021. Disponível em: https://doi.org/10.1093/eurheartj/ehab368. Acesso em: 29 jun. 2025.
MILLER, E.; TOPKARA, V. Bridge to transplantation from mechanical circulatory support. Journal of Thoracic Disease, [S. l.], 2023. Disponível em: https://jtd.amegroups.org/article/view/58216. Acesso em: 2 jul. 2025.
NETUKA, I. et al. First Clinical Experience With the Pressure Sensor–Based Autoregulation of Blood Flow in an Artificial Heart. ASAIO Journal, v. 67, n. 10, p. 1100–1108, 2021. Disponível em: https://doi.org/10.1097/mat.0000000000001485. Acesso em: 29 jun. 2025.
SCHRODER, J. N. et al. The First Autoregulated Total Artificial Heart Implant in the United States. Annals of Thoracic Surgery Short Reports, v. 1, n. 1, p. 185–187, 2023. Disponível em: https://doi.org/10.1016/j.atssr.2022.09.007. Acesso em: 29 jun. 2025.
SHREENIVAS, S. S.; RAME, J. E.; JESSUP, M. Mechanical circulatory support as a bridge to transplant or for destination therapy. Current Heart Failure Reports, v. 7, n. 4, p. 159–166, 2010. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970816. Acesso em: 2 jul. 2025.
THYLÉN, I.; JAARSMA, T.; INGADOTTIR, B. Device adjustment and recovery in patients with heart failure undergoing a cardiac resynchronization therapy implantation: A longitudinal study: A longitudinal study. The Journal of cardiovascular nursing, v. 37, n. 3, p. 221–230, 2022. Disponível em: https://doi.org/10.1097/jcn.0000000000000795. Acesso em: 29 jun. 2025.
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Copyright (c) 2025 Rafaella Khouri Fernandes, Luccas de Araújo Pereira, Larissa Sobrinho Aniceto , Fernanda julia de Barros, Yasmin Quirino Queiros, Dioelen Virginia Borges Souza de Aquino Coelho
