Total Artificial Hearts-Past, Current, and Future

Fox, Sarah; McKenna, Kelli L.; Allaire, Paul E.; Mentzer, Robert M.; Throckmorton, Amy L.

doi:10.1111/jocs.12644

Cited by 16 publications

(23 citation statements)

References 45 publications

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“…However, LVADs are not appropriate for many patients such as those requiring biventricular support or with complex congenital heart disease. Using two VADs to mechanically support both ventricles has been proposed , but challenges in maintaining appropriate left/right flow balance between two independent devices, and the increased peripherals typically needed to run two separate pumps has limited the adoption of this technique . For patients requiring biventricular support, a total artificial heart (TAH) would be ideal.…”

mentioning

confidence: 99%

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop

Glynn¹,

Song

Hull³

et al. 2017

Artificial Organs

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Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation. To validate the design, a TAH prototype was placed in a mock circulatory loop that simulates vascular resistance, pressure, and compliance in normal and pathophysiologic conditions. At a systemic blood pressure of 120/80 mm Hg, nominal TAH output was 7.4 L/min with instantaneous flows reaching 17 L/min. Pulmonary artery, and left and right atrial pressures were all maintained within normal ranges. To simulate implant into a patient with severe pulmonary hypertension, the pulmonary vascular resistance of the mock loop was increased to 7.5 Wood units. By increasing pump speed to the pulmonary circulation, cardiac output could be maintained at 7.4 L/min as mean pulmonary artery pressure increased to 56 mm Hg while systemic blood pressures remained normal. This in vitro testing of a novel, shuttling TAH demonstrated that cardiac output could be maintained across a range of pathophysiologic conditions including pulmonary hypertension. These experiments serve as a proof-of-concept for the design, which has proceeded to in vivo testing.

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mentioning

confidence: 99%

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop

Glynn¹,

Song

Hull³

et al. 2017

Artificial Organs

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show abstract

“…Another approach is the dual‐use of VADs for biventricular mechanical circulatory support (BiVADs) . Several were successful as bridge‐to‐transplant alternatives, but the majority of these pumps are not designed to operate as pulmonary or right‐sided VADs.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Continuous‐Flow Total Artificial Heart

et al. 2018

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Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure. This TAH has only two moving parts: an axial impeller for the pulmonary circulation and a centrifugal impeller for the systemic circulation. This device will utilize the latest generation of magnetic bearing technology. Initial geometries were established using pump design equations, and computational modeling provided insight into pump performance. The designs were the basis for prototype manufacturing and hydraulic testing. The study results demonstrate that the TAH is capable of delivering target blood flow rates of 1-6.5 L/min with pressure rises of 1-92 mm Hg for the pulmonary circulation and 24-150 mm Hg for the systemic circulation at 1500-10 000 rpm. This initial design of the TAH was successful and serves as the foundation to continue its development as a novel, more compact, nonthrombogenic, and effective therapeutic alternative for infants, children, adolescents, and adults with heart failure.

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“…The transcutaneous energy transmission (TET) system, utilized in the AbioCor TAH (Abiomed, Danvers, MA, USA) and LionHeart LVAD (formerly Arrow International, Reading, PA, USA) offered wireless inductive power transfer between an internal and external coil that communicates across intact skin. 12,13 Despite the success of TET in reducing infection, the reliability of power transfer is limited by tissue density and coil misalignment. In addition to unreliable power transmission, TET consumes nearly 20% of the power transferred to implanted device during operation, making this technology less energy efficient.…”

Section: Energy Transfermentioning

confidence: 99%

“…Efforts to develop alternative energy transfer systems that eliminate percutaneous drivelines and associated complications are ongoing. The transcutaneous energy transmission (TET) system, utilized in the AbioCor TAH (Abiomed, Danvers, MA, USA) and LionHeart LVAD (formerly Arrow International, Reading, PA, USA) offered wireless inductive power transfer between an internal and external coil that communicates across intact skin 12,13 . Despite the success of TET in reducing infection, the reliability of power transfer is limited by tissue density and coil misalignment.…”

Section: Effective and Efficient Energy Transfermentioning

confidence: 99%

On the path to permanent artificial heart technology: Greater energy independence is paramount

2021

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Total Artificial Hearts-Past, Current, and Future

Abstract: We present a review of the evolution of total artificial hearts (TAHs) and new directions in development, including the coupling of VADs as biventricular TAH support.

Cited by 16 publications

References 45 publications

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop

Hybrid Continuous‐Flow Total Artificial Heart

On the path to permanent artificial heart technology: Greater energy independence is paramount

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