Eight-year experience with a continuous-flow total artificial heart in calves

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Devices

Background:

• The development of a continuous-flow total artificial heart (CFTAH) is crucial for managing end-stage heart failure.
• Understanding the physiological impact of nonpulsatile circulation is essential for advancing cardiac replacement therapies.

Purpose of the Study:

• To evaluate the physiological and hemodynamic effects of a CFTAH in a large animal model.
• To assess the long-term performance and biocompatibility of a CFTAH over 90 days.

Main Methods:

• A CFTAH, comprising two rotary blood pumps, was implanted in 65 calves.
• Physiological parameters (pressures, pump flow) were continuously monitored; hematologic, biochemistry, and necropsy analyses were performed.
• Treadmill evaluations assessed physiological responses during exercise.

Main Results:

• Calves survived for up to 90 days (mean 24 days) with acceptable physiological parameters and pump function.
• Hematologic and biochemistry values remained within acceptable ranges.
• End-organ appearance was unremarkable in long-term survivors, with CFTAH circuits free of thrombus.

Conclusions:

• A CFTAH can physiologically and hemodynamically support large animals for up to 90 days.
• The continuous-flow design demonstrates potential for long-term cardiac replacement.
• Further research into CFTAH technology is warranted for clinical application.