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Updated: Aug 7, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Anatomic constraints for a total artificial heart in orthotopic heart transplant recipients
Insights
Defining anatomic constraints for artificial heart prostheses in heart transplant recipients is crucial. This study measured pericardial dimensions to ensure proper fit for total artificial hearts, finding current designs acceptable for implantation.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Medical Device Design
Background:
- Heart transplant recipients are ideal candidates for total artificial hearts (TAHs).
- Anatomical constraints and design parameters for TAHs in this population are not well-defined.
- Existing TAH models require evaluation within the specific anatomical context of transplant recipients.
Purpose of the Study:
- To define the anatomical constraints of the pericardial cavity in heart transplant recipients.
- To evaluate the fit of a TAH model based on these constraints.
- To identify key anatomical variables influencing TAH prosthesis fit.
Main Methods:
- Measurements of pericardial constraints were taken in 26 patients undergoing orthotopic heart transplantation.
- A full-sized contour model of a TAH was inserted into the pericardial cavity to assess fit.
- Excised hearts were also measured to provide reference data for prosthetic device development.
Main Results:
- The TAH model demonstrated adequate fit in most patients without compressing adjacent vascular structures.
- Median intraoperative pericardial measurements were length 130 mm, width 160 mm, and depth 140 mm.
- Pericardial length and cardiothoracic ratio were identified as significant factors affecting prosthesis fit.
Conclusions:
- The current dimensions of the studied implantable TAH are suitable for orthotopic implantation.
- Understanding pericardial dimensions is essential for optimizing TAH design and ensuring successful implantation.
- This research provides critical data for the development of future artificial heart prostheses.
Abstract:
The anatomic constraints and design parameters for a heart prosthesis have not yet been defined in heart transplant recipients (i.e., the population most eligible for total artificial heart implantation). The parameters regarding anatomic constraints were measured in 26 consecutive patients undergoing orthotopic heart transplantation (median body surface area 1.9 m2) after cardiectomy. A full-sized contour model of the cylindric total artificial heart (diameter 97 mm; width 81 mm) was inserted into the pericardial cavity to decide the pump configuration and to verify its fit. The dimensions of this model were based on the miniature electromechanical total artificial heart that is currently under development. Fit was found to be adequate in most of the cases with no identifiable compression of adjacent vascular structures. The median intraoperative measurements that define pericardial constraints for a heart prosthesis were pericardial length (130 mm), width (160 mm), and depth (140 mm). We also took measurements from the excised hearts, which should provide a useful reference for other prosthetic devices. The current dimensions of our implantable total artificial heart were found acceptable for orthotopic implantation. Length of the pericardium and cardiothoracic ratio were identified as variables related to adequacy of fit.
