Initial Experience with the AbioCor Implantable Replacement Heart at the University of Louisville

Abstract

Potential benefits of heart transplantation are limited by the severe donor organ shortage. The AbioCor implantable replacement heart has been developed as a potential alternative to heart transplantation. We report our initial experience with the AbioCor in a bovine model. A right thoracotomy was performed for access to the heart and great vessels. After initiation of cardiopulmonary bypass, excision of the native ventricles was followed by orthotopic placement of the IRH and complete implantation of the transcutaneous energy transfer coil, controller, and battery pack. Invasive monitoring of IVC, SVC, carotid artery, pulmonary artery, and left atrial (LA) pressures was performed in all animals. Twelve calves have undergone implantation of the AbioCor. There were three early deaths, one from bleeding, one from respiratory failure, and one from neurodysfunction from low flow during CPB. Nine animals have had a normal recovery and survived a mean of 24.5 days (range, 4-48 days). All the animals have demonstrated excellent hemodynamics with the maintenance of normal pressures in the LA, SVC, IVC, pulmonary artery, and aorta. Adjustment of the right-sided internal hydraulic fluid shunt has allowed for control of right-left balance and, thereby, manipulation of left and right side filling pressures. Late morbidity has consisted of neck wound infection and sepsis, pneumonia, and bleeding. Successful orthotopic implantation of all components of the AbioCor has been achieved in a bovine model. This device has demonstrated restoration of normal hemodynamics and excellent function of the atrial hydraulic shunt to achieve right-left balance.

Sélection des matériaux pour la conception et le développement du boîtier d'un cœur artificiel total implantable : supériorité du titane et de ses alliages

“…La première tentative chez l'humain eut lieu en 1969 [101] et les premiers essais cliniques qui faisaient appel à un système de compresseurs, représentent une technologie dépassée [102,103]. Les essais réalisés au cours des dernières années avec le coeur artificiel AbioCor ® ouvrent de nouvelles avenues qui devraient entraîner une amélioration significative des équipements disponibles [104]. Il s'agit surtout d'espérer un déblocage intellectuel.…”

Virtual implantations to transition from porcine to bovine animal models for a total artificial heart

“…The weight correlated well with the thorax measurement over arcus in animals weighing 80‐106 kg. TAH developers of small continuous flow devices typically use calves within this size range (BiVACOR: 71 kg, CCFTAH: 77‐93.9 kg), whereas developers of larger pulsatile TAHs typically use calves of a larger weight range (AbioCor: 85‐115 kg, CARMAT: 102‐120 kg). In this study, the data from larger calves is limited, but there is an indication that the thorax may not grow at the same rate past 106 kg, and therefore that thorax measurements and/or virtual implantations should be performed to ensure the thoracic size is suitable prior to implantation.…”

Treadmill Exercise in Calves Implanted with the AbioCor Replacement Heart

“…11 The AbioCor was implanted in six male Holstein calves with a weight range of 85-115 kg. All and were displayed on a clinical monitoring system (HewlettPackard Model 66, Andover, MA).…”