Abstract

Background: Total artificial hearts (TAH) may be anatomically unsuitable for implantation in 60% of the population (small adults, children). Continuous flow pumps are smaller, more power-efficient, and conducive to biventricular replacement. We used dual Jarvik 2000 Flowmakers as a TAH in a juvenile bovine model. Methods: Ventricles were transected below the atrial junction. A pericardial patch was sewn to each ventricular remnant to support the pump sewing ring. Aorta (Ao) and pulmonary artery (PA) were transected above the valves for end-to-end anastomosis of outflow grafts. Pump speed was constant (14 Krpm) on the left and varied (8–12 Krpm) on the right. Vascular resistances were managed pharmacologically. Results: Pump flows (L/min) averaged 7.6±1.1 on the left and 7.2±1.1 on the right. Pressures (mmHg) were 98±17 (Ao), 19±6 (PA), 12±7 (LA), and 17±6 (RA). End-organ function and blood ANF, TNF, ACE and catecholamine levels remained normal. The animal died on day 20 when right pump controller accidentally separated from its power supply. Conclusion: We showed feasibility of an implantable, constant-flow TAH. Preload sensitivity of rotary pumps allowed adequate compensation of left-sided flow imbalance without an ASD or internal balancing mechanism.Figure

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