BackgroundThe pediatric continuous-flow total artificial heart (P-CFTAH) is a novel double-ended centrifugal pump designed with the intent to provide circulatory support for pediatric heart failure. ObjectivesTo enable continuous monitoring of pump hemodynamics, Hall effect sensors (HES) were embedded inside the P-CFTAH design to track both axial movement and position of the pump rotor post-implantation. Herein, we report an early in vivo evaluation of the P-CFTAH with HES, implanted in small-sized ovine models. MethodsFive healthy lambs were used for the P-CFTAH implantation via a full median sternotomy and cardiopulmonary bypass support. Successful evaluation of the P-CFTAH was achieved in four out of five (n = 4, 20.9 ± 1.3 kg). The hemodynamics and operating conditions were continuously recorded with varying pump speeds (2,800-5,000 rpm), systemic/pulmonary vascular resistance ratio, and high- and low-volume conditions. Among the four cases, P-CFTAH with HES embedded in the rotor was used in two cases. ResultsAll surgical procedures were uneventful, and the optimal anatomical fit of the pump was shown in the chest. Differences between the left and right atrial pressures were mostly maintained within the intended limit of ± 10 mm Hg throughout the design range of systemic and pulmonary vascular resistance. The HES accurately traced the rotor position, showing a positive correlation with atrial pressure differences. ConclusionsThe findings suggest that the P-CFTAH has the potential to provide self-balancing circulatory support for pediatric heart failure patients. The study contributes to the development of a pediatric-sized total artificial heart with improved monitoring.