TY - JOUR
T1 - First In Vivo Experience With Biventricular Circulatory Assistance Using a Single Continuous Flow Pump
AU - Karimov, Jamshid H.
AU - Horvath, David J.
AU - Miyamoto, Takuma
AU - Kado, Yuichiro
AU - Gao, Shengqiang
AU - Kuban, Barry D.
AU - Polakowski, Anthony R.
AU - Sale, Shiva
AU - Fukamachi, Kiyotaka
N1 - Funding Information:
We are thankful to our Cleveland Clinic colleagues Patrick Grady, Director, Perfusion Services; Jianzhong Cang, Research Engineer, Polymer Core, Medical Device Solutions; Kimberly A. Such, DVM, DACLAM, Biological Resources Unit; and Laura Konczos, Manager, GCIC Incubator & Preclinical Programs, and Jacqueline Kattar, both of Cleveland Clinic Innovations. Their significant efforts and assistance with these studies is appreciated. Funding: This work was supported with Cleveland Clinic's internal funding. The P-CFTAH device was developed by federal funding obtained from the National Heart, Lung and Blood Institute, National Institutes of Health, under grant 1R01HL139984.
Funding Information:
Funding: This work was supported with Cleveland Clinic's internal funding. The P-CFTAH device was developed by federal funding obtained from the National Heart, Lung and Blood Institute, National Institutes of Health, under grant 1R01HL139984.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Biventricular assist device (BVAD) implantation is the treatment of choice in patients with severe biventricular heart failure and cardiogenic shock. Our team has developed a miniaturized continuous flow, double-ended centrifugal pump intended for total artificial heart implant (CFTAH). The purpose of this initial in vivo study was to demonstrate that the scaled-down CFTAH (P-CFTAH) can be appropriate for BVAD support. The P-CFTAH was implanted in 4 acute lambs (average weight, 41.5 ± 2.8 kg) through a median sternotomy. The cannulation was performed through the left and right atria, and cannulae length adjustment was performed for atrial and ventricular cannulation. The BVAD system was tested at 3 pump speeds (3000, 4500, and 6000 rpm). The BVAD performed very well for both atrial and ventricular cannulation within the 3000–6000 rpm range. Stable hemodynamics were maintained after implantation of the P-CFTAH. The self-regulating performance of the system in vivo was demonstrated by the left (LAP) and right (RAP) pressure difference (LAP-RAP) falling predominantly within the range of −5 to 10 mm Hg with variation, in addition to in vitro assessment of left and right heart failure conditions. Left and right pump flows and total flow increased as the BVAD speed was increased. This initial in vivo testing of the BVAD system demonstrated satisfactory device performance and self-regulation for biventricular heart failure support over a wide range of conditions. The BVAD system keeps the atrial pressure difference within bounds and maintains acceptable cardiac output over a wide range of hemodynamic conditions.
AB - Biventricular assist device (BVAD) implantation is the treatment of choice in patients with severe biventricular heart failure and cardiogenic shock. Our team has developed a miniaturized continuous flow, double-ended centrifugal pump intended for total artificial heart implant (CFTAH). The purpose of this initial in vivo study was to demonstrate that the scaled-down CFTAH (P-CFTAH) can be appropriate for BVAD support. The P-CFTAH was implanted in 4 acute lambs (average weight, 41.5 ± 2.8 kg) through a median sternotomy. The cannulation was performed through the left and right atria, and cannulae length adjustment was performed for atrial and ventricular cannulation. The BVAD system was tested at 3 pump speeds (3000, 4500, and 6000 rpm). The BVAD performed very well for both atrial and ventricular cannulation within the 3000–6000 rpm range. Stable hemodynamics were maintained after implantation of the P-CFTAH. The self-regulating performance of the system in vivo was demonstrated by the left (LAP) and right (RAP) pressure difference (LAP-RAP) falling predominantly within the range of −5 to 10 mm Hg with variation, in addition to in vitro assessment of left and right heart failure conditions. Left and right pump flows and total flow increased as the BVAD speed was increased. This initial in vivo testing of the BVAD system demonstrated satisfactory device performance and self-regulation for biventricular heart failure support over a wide range of conditions. The BVAD system keeps the atrial pressure difference within bounds and maintains acceptable cardiac output over a wide range of hemodynamic conditions.
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U2 - 10.1053/j.semtcvs.2020.03.006
DO - 10.1053/j.semtcvs.2020.03.006
M3 - Article
C2 - 32371175
AN - SCOPUS:85085073545
SN - 1043-0679
VL - 32
SP - 456
EP - 465
JO - Seminars in Thoracic and Cardiovascular Surgery
JF - Seminars in Thoracic and Cardiovascular Surgery
IS - 3
ER -