Hemodynamic regulation in total artificial heart recipients

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Animal Models

Background:

• Total artificial hearts (TAHs) are crucial for end-stage heart failure treatment.
• Understanding hemodynamic and morphological changes post-TAH implantation is vital.
• Previous studies highlight challenges in managing venous pressures with TAHs.

Purpose of the Study:

• To analyze hemodynamic parameters (atrial pressures, blood volume, pump output) in calves with a free-diaphragm-type TAH.
• To investigate morphological changes in atrial myocardium following TAH implantation.
• To introduce and preliminarily evaluate an automatic controller for pusher-plate-type pumps to address high venous pressure.

Main Methods:

• Hemodynamic monitoring of right and left atrial pressures (RAP and LAP), circulating blood volume (CBV), and pump output in 17 calves.
• Histopathological examination of atrial myocardium post-implantation.
• Introduction and preliminary in vivo testing of a novel automatic controller for pusher-plate-type pumps.

Main Results:

• High RAP and increased CBV were consistently observed, while LAP remained near normal.
• A correlation was noted between RAP, CBV, and pump output, which was maintained between 86.6-130.1 ml/min/kg.
• Significant morphological changes, including cellular thickening, were observed in the atrial myocardium after one month.

Conclusions:

• Free-diaphragm-type TAHs in calves can lead to elevated RAP and CBV.
• Morphological changes in the atrial myocardium warrant further investigation.
• The newly developed automatic controller shows potential for managing high venous pressure in TAH systems.