We recently developed a new model of moving actuator type totally implantable artificial heart (TIAH), based on the reverse position of the aortic and pulmonary conduits. This concept was proposed by one of surgeons in our team (Joon-Ryang Rho,
M.
D. )
to facilitate anatomical fitting of TIAHs.
The moving actuator type electromechanical TIAH consisted of the left and right blood sacs, and the moving actuator including a motor. The inverted umbrella type polyurethane valves were used in the blood pumps. The aortic conduit was positioned
anterior to the pulmonary conduit, which was the opposite relation to the conventional configuration of other total artificial hearts. We also adapted slip-in connectors for the aortic and pulmonary conduits.
Two sheep, weighing 60~69 kg, were used for implantation. After small cervical incision and trans-sternal bilateral thoracotomy, cardiopulmonary bypass (CPB) was administered using an American Optical 5-head pump and a membrane oxygenator
(Univox-IC,
Bentley). The anterior and posterior vena cavae were drained separately for venous return. An arterial return cannula was inserted into the right common carotid artery. During CPB, almost all of the ventricular myocardium was excised down to the
atrioventricular groove and the artificial heart was implanted.
We achieved 3-day survival in the first sheep and 2-day survival in the second. The day after operation the first sheep was successfully extubated and the second sheep was weaned from a respirator with good condition. After extubation, the first
sheep
walked around in the cage and fed herself. Serial laboratory and hemodynamic examinations were done during the experiments. In both sheep, pulmonary dysfunction was gradually developed, which was accompanied by acute renal failure. The animals
were
sacrificed and autopsy was done. Unexpected pregnancy was incidentally found in both sheep. To our knowledge this is the first report of significant survival cases in the orthotopic implantation of electric TIAH using sheep.
(Korean J Thorac Cardiovasc Surg 1995;28:533-41)
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