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Updated: Jun 25, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Total right ventricular exclusion improves left ventricular function in patients with end-stage congestive right
Masami Takagaki1, Kozo Ishino, Masaaki Kawada
1Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama, Okayama, 700-8558, Japan.
Total right ventricular exclusion surgery effectively treats severe heart failure by removing RV volume overload. This procedure normalizes left ventricular shape and significantly improves its function and systemic output.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Adult Congenital Heart Disease
Background:
- Isolated congestive right ventricular (RV) failure presents a significant clinical challenge.
- The total RV exclusion procedure was developed to address this condition by removing RV volume overload (RVVO).
Purpose of the Study:
- To evaluate the functional impact of complete RVVO removal on a surgically created single left ventricle (LV).
Main Methods:
- Eight patients (3 adults, 5 children) with end-stage RV failure underwent RV free wall resection and tricuspid orifice closure.
- Pulmonary blood supply was established via cavopulmonary connection or systemic-pulmonary shunt.
- Left ventricular function was assessed using 2D echocardiography one month post-surgery.
Main Results:
- All patients survived the procedure.
- Interventricular septum movement and LV geometry (eccentricity) normalized significantly (P<0.01).
- LV end-diastolic volumes, indexed maximal left atrial area, LV ejection fraction, and cardiac index all demonstrated significant improvements (P<0.01 for most).
Conclusions:
- Total RV exclusion effectively unloads the RV, improving LV volume loading and restoring a more cylindrical shape.
- The procedure enhances LV contractile function, leading to a significant increase in systemic output.
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