Bishawi Muath, Roan Jun-Neng, Richards Jordan, Brown Zachary, Blue Laura, Daneshmand Mani A, Schroder Jacob N, Bowles Dawn E, Milano Carmelo A
Division of Cardiothoracic Surgery, Department of Surgery, Duke University;
Division of Cardiothoracic Surgery, Department of Surgery, Duke University; Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine.
J Vis Exp. 2018 May 11(135):55961. doi: 10.3791/55961.
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.
机械循环支持（MCS）主要通过使用体内心室辅助装置（VAD）来支持左心室，已被引入作为心脏移植的一种可行替代方案。然而，某些临床情况需要双心室机械支持。对于一些患者，一种策略是切除两个心室并植入两个VAD泵作为全人工心脏（TAH）。最近，由于设备设计的改进和离心设备的小尺寸，这已成为可能。这种TAH方法仍处于实验阶段，面临许多重要挑战，如平衡左右循环的设备设置、设备及流出道移植物的方向及其对溶血和稳定性的影响，以及使用这种方向进行长期支持的结果。本方案旨在为在奶牛模型中用两个体内离心VAD进行全人工心脏置换提供一种可重复的方法。
