Initial in vitro testing of a paediatric continuous-flow total artificial heart

Area of Science:

• Biomedical Engineering
• Pediatric Cardiology
• Cardiovascular Surgery

Background:

• Mechanical circulatory support is standard for adult heart failure, but pediatric options for congenital heart disease are limited.
• Congenital heart disease often affects both ventricles, requiring biventricular support like heart transplantation or a total artificial heart.
• Current pediatric mechanical circulatory support options are limited to paracorporeal devices or adult devices used off-label.

Purpose of the Study:

• To evaluate the in vitro performance of a novel pediatric continuous-flow total artificial heart prototype.
• To assess the device's ability to support both pulmonary and systemic circulations in a simulated pediatric setting.

Main Methods:

• A pediatric continuous-flow total artificial heart prototype was developed by downscaling an adult device.
• In vitro performance was evaluated using a mock loop simulating pediatric circulation.
• Pump performance and atrial pressure differences were mapped across various systemic and pulmonary vascular resistance and pump speeds.

Main Results:

• The pediatric total artificial heart prototype demonstrated a left pump flow range of 0.4-4.7 L/min at 100 mmHg delta pressure.
• Atrial pressure balance was maintained within ±5 mmHg across a wide range of vascular resistance ratios (1.4-35).
• The device exhibited passive self-regulation of atrial pressure, meeting design requirements.

Conclusions:

• The pediatric continuous-flow total artificial heart prototype meets initial design requirements for self-regulation and performance.
• Further in vivo studies are underway to validate the device's efficacy.
• This development offers a potential advancement in mechanical circulatory support for pediatric end-stage heart failure.