Percutaneous access devices in calves receiving an artificial heart

Area of Science:

• Veterinary medicine
• Biomedical engineering
• Cardiovascular research

Background:

• Vegetative endocarditis and thromboembolism are primary causes of mortality in calves supported by total artificial hearts (TAH).
• Percutaneous access devices (PAD) for TAH drive lines are frequently infected, serving as a source for vegetative lesions.
• Infections often originate at the dorsal surface of the PAD, linked to skin ulceration or avulsion.

Purpose of the Study:

• To investigate the causes of PAD infections in calves with TAH.
• To evaluate the efficacy of a new PAD design and implantation technique in reducing infections.

Main Methods:

• Observation of 80 calves with TAHs to identify infection origins.
• Necropsy evaluation of 58 PAD specimens for flange positioning and infection.
• Comparative analysis of infection rates between old and new PAD designs in 11 animals.

Main Results:

• Improper flange positioning (76%) and gross infection (57%) were prevalent in older PAD designs.
• The new implantation technique and PAD design improved flange positioning and reduced skin interface irritation.
• Necropsies of animals with the new PAD showed a significant reduction in superficial infections.

Conclusions:

• PAD infections are a critical issue in TAH research in calves.
• Improved PAD design and implantation technique effectively mitigate superficial infections.
• Further research is warranted to fully address endocarditis and thromboembolism in TAH recipients.