First In Vivo Experience With Biventricular Circulatory Assistance Using a Single Continuous Flow Pump

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Medical Devices

Background:

• Biventricular assist device (BVAD) implantation is critical for severe biventricular heart failure and cardiogenic shock.
• A novel miniaturized continuous flow, double-ended centrifugal pump for total artificial heart (CFTAH) implant has been developed.

Purpose of the Study:

• To evaluate the suitability of a scaled-down CFTAH (P-CFTAH) for biventricular assist device support.
• To demonstrate the in vivo performance and self-regulating capabilities of the P-CFTAH in an animal model.

Main Methods:

• The P-CFTAH was implanted in 4 acute lambs (average weight 41.5 ± 2.8 kg) via median sternotomy.
• Cannulation involved the left and right atria, with adjustments for atrial and ventricular access.
• The BVAD system was tested at pump speeds of 3000, 4500, and 6000 rpm.

Main Results:

• The BVAD demonstrated excellent performance across atrial and ventricular cannulation at 3000-6000 rpm.
• Stable hemodynamics were maintained post-implantation, with a left-right atrial pressure difference (LAP-RAP) of -5 to 10 mm Hg.
• Increased pump speeds led to higher left, right, and total pump flows, indicating effective cardiac output regulation.

Conclusions:

• The P-CFTAH shows satisfactory device performance and self-regulation for biventricular heart failure support.
• The BVAD effectively manages atrial pressure differences and maintains acceptable cardiac output under various hemodynamic conditions.
• This initial in vivo study supports the potential of the P-CFTAH as a viable BVAD option.