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Long-term circulatory maintenance with a left-sided single artificial heart
H Takano1, Y Taenaka, T Nakatani
1Department of Artificial Organs, National Cardiovascular Center, Research Institute, Osaka, Japan.
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1992
Summary
A single left artificial heart can sustain circulation during cardiac arrest if pulmonary vascular resistance is low and plasma protein levels are high. This artificial heart provides a bridge to potential heart transplantation.
Area of Science:
- Biomedical Engineering
- Cardiovascular Physiology
- Artificial Organs
Background:
- Non-functioning hearts necessitate advanced circulatory support.
- The development of artificial hearts aims to bridge patients to transplantation or recovery.
Purpose of the Study:
- To assess the feasibility of long-term circulatory support using a single left artificial heart.
- To evaluate the device's efficacy in maintaining hemodynamics during cardiac arrest.
Main Methods:
- Short-term hemodynamic assessments in goats (n=4).
- Long-term feasibility studies in goats (n=12) with cardiac arrest.
- Monitoring of pulmonary vascular resistance, right atrial pressure, flow rates, and mean arterial pressure.
Main Results:
- Circulation was maintained with the artificial heart alone when pulmonary vascular resistance was <15,000 dynes.sec.cm-5.kg and right atrial pressure was 14-16 mm Hg.
- Flow rates ranged from 80-140 ml/kg/min, with mean arterial pressure >80 mm Hg.
- Pleural effusion was a challenge, but maintaining plasma total protein >6.0 gm/dl mitigated this; longest survival was 38 days.
Conclusions:
- A single left artificial heart can effectively maintain circulation under specific physiological conditions (PVR < 2x normal, Total Protein > 6.0 gm/dl).
- This technology offers a potential temporary solution for patients awaiting heart transplantation.