Anatomic fitting studies of a total artificial heart in heart transplant recipients. Critical dimensions and prediction of fit.
Anatomic fitting studies of the Cleveland Clinic-Nimbus total artificial heart were performed in 33 patients undergoing heart transplantation. The pump fit in the pericardial space in 20 men (80%) and 4 women (50%). There was no significant difference between the Fit and Non-Fit groups in external chest dimensions. Among 42 intrathoracic dimensions, the distance from the center of the mitral valve to the diaphragm (Fit: 5.6 +/- 2.2 cm, Non-Fit: 3.6 +/- 0.4 cm, p < 0.00001) and the distance from the caudal end of the pulmonary valve to the diaphragm (Fit: 9.4 +/- 1.6 cm, Non-Fit: 6.3 +/- 0.8 cm, p < 0.0001) were the most critical. To predict anatomic fit, an index (A x B x C) was obtained from chest X-ray measurements (A, the craniocaudal distance from the dorsal region of the 8th left rib to the left diaphragm; B, the maximum left chest width; and C, the maximum anteroposterior sternum-vertebrae dimension). The pump fit in 88.5% of the patients with an index above 1200 cm3, whereas it fit in only 14.3% of the patients with an index below 1200 cm3 (p < 0.001). This index was an easily obtainable, good predictor of anatomic fit.
Fukamachi
K
K
Department of Biomedical Engineering, Cleveland Clinic Foundation, OH 44195, USA.
McCarthy
P M
PM
Vargo
R
R
Massiello
A L
AL
Chen
J F
JF
Byerman
B P
BP
Kunitomo
R
R
Matsuyoshi
T
T
Okazaki
Y
Y
Kiraly
R J
RJ
Butler
K C
KC
Harasaki
H
H
D003964:Diaphragm / Q000033:anatomy & histology; D005069:Evaluation Studies as Topic; D005260:Female; D016027:Heart Transplantation; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000033:anatomy & histology; D018579:Patient Selection; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000033:anatomy & histology; D013902:Radiography, Thoracic; D013909:Thorax / Q000033:anatomy & histology