Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Abstract

Mechanical circulatory support (MCS) has been introduced as a viable alternative to heart transplantation primarily through the use of intracorporeal ventricular assist devices (VADs) for support of the left ventricle. However, certain clinical scenarios warrant biventricular mechanical support. One strategy for some patients is the excision of both ventricles and the implantation of two VAD pumps as a total artificial heart (TAH). This has recently been made possible by the improvements in device design and the small profile of centrifugal devices. This TAH approach remains experimental with many important challenges such as the device settings to balance the right and left circulation, the orientation of the devices and the outflow graft with their influence on hemolysis and stability, and the outcome of chronic support using such an orientation. This protocol aims to provide a reproducible approach for total artificial heart replacement with two intracorporeal centrifugal VADs in a cow model.

High Performance Artificial Muscles to Engineer a Ventricular Cardiac Assist Device and Future Perspectives of a Cardiac Sleeve

“…[ 11 ] Nonetheless, the VADs use rigid components, bulky power systems made from metals or plastic which are unsuitable for use in some heart patients due to the size limitations. [ 16,17 ] In addition, driveline infections associated with external energy source, and the non‐pulsatile blood flow in left VADs has led to new complications such as increased aortic valve regurgitation and spontaneous bleedings. [ 18,19 ] Therefore, reviewers emphasized the importance of miniaturization, speed modulation, total implantability, and preservation of pulsatility with no contact with blood.…”