[The contribution of artificial heart research in Czechoslovakia to modern medical science].
A summary of the development of total artificial heart research in Czechoslovakia is presented. The experimental setting of this research was based mainly on experiments on calves and partially on goats. The original concept of the blood pump is represented by an asymmetrical type of pump with an asymmetrical diaphragm and undulating motion of the diaphragm allowing optimal washing of the blood chamber. This is the key factor of the antithrombogenic properties of the latest version of the Brno artificial heart. For the pneumatic drive of the artificial heart control and driving units of our own construction--Chirasist-TN-3--are used. In 50 completed long-term experiments the mean survival time was 117.4 days. In the group of 23 experiments with polyurethane total artificial heart (TAH) the mean survival time was 133.9 days. The longest survival was achieved in the calf "Artur", No. 121 with 293 days of pumping which is worldwide one of the three longest survival times with TAH using the calf as an experimental animal. The experiment with an intrathoracic TAH implantation in the goat with a survival time of 184 days represents a worldwide unique success. After solving a number of technical and biological problems, we focused our attention on two crucial complications, i.e. increased central venous pressure leading to severe liver damage and diaphragm calcification. The original Brno concept concerned with the pathomechanism of central venous pressure increase made efficient pathogenetic therapy feasible and resulted in a marked protection of liver functions, so that increased venous pressure is no longer a problem in our experiments that would limit the period of survival. However diaphragm calcification has remained a serious survival limiting complication and therefore prevention of calcification is in the focus od our intensive research activities. Parallelly with these activities we have been engaged in research aimed at the clinical application of the TAN to bridge the period in severely affected patients until a suitable heart transplant is available. So far we have performed four artificial heart implantations in patients in the final stage of heart failure. We could keep these four patients on the TAH from one to ten days without the slightest failure of the system, and the blood chambers of the TAH-TNS-BRNO--VII/Klin/80, removed from the patient's chest after pumping had been stopped, were completely free of thrombi.(ABSTRACT TRUNCATED AT 400 WORDS)
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D000818:Animals; D002417:Cattle; D003604:Czechoslovakia; D006041:Goats; D006354:Heart, Artificial; D012106:Research
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