{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:44:01Z","timestamp":1792514641585,"version":"4.5.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Refractory advanced biventricular heart failure (RAHF) has a poor prognosis, and many patients are ineligible for left ventricular assist device (LVAD) support. The \u2018historical\u2019 total artificial heart (TAH) is associated with high rates of stroke, bleeding, and haemolysis. The bioprosthetic TAH (bio-TAH), a pulsatile, auto-regulated, and haemocompatible device, was assessed here as a bridge to transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>EFICAS (NCT04475393) was a prospective, multi-centre trial conducted at 10 French centres. Adults with RAHF who were ineligible for LVAD support and listed or eligible for heart transplantation were enrolled. The primary composite endpoint was survival at 180 days free from disabling stroke, device malfunction requiring reoperation or urgent transplantation, or elective heart transplantation. Secondary endpoints included serious adverse events, New York Heart Association (NYHA) class, the 6-min walk test, and quality-of-life measured using the EQ-5D-5L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-five patients underwent implantation (December 2022 and May 2025; median age, 56 years [IQR, 48\u201363]; 49% INTERMACS profiles 1\u20132; 36% on venoarterial extracorporeal membrane oxygenation). The primary endpoint was achieved in 40 patients (72.7%; 95% confidence interval, 57.1\u201385.1), exceeding the pre-specified \u2018historical TAH\u2019 threshold of 38% (P &amp;lt; .0001). At 180 days, 96% were free of disabling stroke, 76% were discharged, and 92% were NYHA class I-II. Median 6-minute walk distance improved by 305\u2005m (P = .0002) and EQ-5D by 40 points (P &amp;lt; .0001). No haemolysis occurred, and major bleeding was limited to the first 30 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The bio-TAH achieved its primary endpoint with a favourable safety profile, supporting its use as an effective bridge-to-transplant strategy in patients with RAHF ineligible for LVAD support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehag704","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:46:33Z","timestamp":1787312793000},"source":"Crossref","is-referenced-by-count":0,"title":["Auto-regulated bioprosthetic total artificial heart as bridge to transplantation: the EFICAS study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4081-786X","authenticated-orcid":false,"given":"Andre","family":"Vincentelli","sequence":"first","affiliation":[{"name":"Heart and Lung Institute, Cardiac Surgery Department, CHU Lille, F-59000 ,","place":["France"]},{"name":"Lille University INSERM UMR1011, , Lille F-5900 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Celine","family":"Martin","sequence":"additional","affiliation":[{"name":"Advanced Heart Failure Unit, Cardiology Department, INSERM, PARCC, European Hospital Georges Pompidou\u2014University Paris Cite , Paris F-75000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7414-3176","authenticated-orcid":false,"given":"Julien","family":"Guihaire","sequence":"additional","affiliation":[{"name":"Marie Lannelongue Hospital, Cardiac Surgery, Paris Saclay University , Le Plessis Robinson 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,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwan","family":"Flecher","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Rennes University Hospital , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1192-8704","authenticated-orcid":false,"given":"Philippe","family":"Gaudard","sequence":"additional","affiliation":[{"name":"Cardiothoracic Anaesthesiology and Critical Care Medicine Department, Montpellier University Hospital, PHYMEDEXP, INSERM, University of Montpellier , Montpellier ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles-Henri","family":"David","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, Nantes University Hospital , Nantes F-44000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-6977","authenticated-orcid":false,"given":"Jean-Christian","family":"Roussel","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, Nantes University Hospital , Nantes F-44000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8884-4395","authenticated-orcid":false,"given":"Michel","family":"Kindo","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, CHU Strasbourg , Strasbourg ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Jungling","sequence":"additional","affiliation":[{"name":"Heart and Lung Institute, Cardiac Surgery Department, CHU Lille, F-59000 ,","place":["France"]},{"name":"Lille University INSERM UMR1011, , Lille F-5900 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