Modifications in surgical implantation of the Penn State electric total artificial heart.
BACKGROUND
Two modifications of the surgical implantation protocol for the Penn State Total Artificial Heart (ETAH) were evaluated: Phrenic nerve ischemia was prevented by minimizing dissection and traction; and hemostasis was augmented and ETAH cuff anastomoses reinforced by using fibrin glue.


METHODS
Thirteen Holstein calves underwent orthotopic surgical implantation of the Penn State ETAH between February 1998 and August 2000. Mean hemodynamic and laboratory chemistry variables from the first postoperative week were compared between calves receiving the original (n = 7) and modified (n = 6) protocol.


RESULTS
Calves assigned to the modified protocol displayed an improvement in the Po2/FiO2 ratio compared to original (419.4 +/- 17.5 vs 336.3 +/- 35.4, respectively; p = 0.05). All additional parameters were equivalent between groups. The percent survival of animals receiving the modified protocol at 2, 4, and 12 weeks was higher than that of animals that underwent the original protocol. Original-protocol calf deaths consisting of hemothorax (n = 3), and respiratory failure (n = 1) were prevented in the modified protocol.


CONCLUSIONS
Our results suggest that manipulations in surgical protocol may promote increased survival in calves implanted with the Penn State ETAH.
Department of Surgery and Artificial Organs, Penn State University College of Medicine, Hershey, Pennsylvania 17033, USA.
E M
EM
Hoenicke
R G
RG
Strange
W J
WJ
Weiss
A J
AJ
Snyder
M A
MA
Rawhouser
G
G
Rosenberg
G A
GA
Prophet
W E
WE
Pae
B C
BC
Sun
W S
WS
Pierce
D000818:Animals; D002417:Cattle; D002423:Cause of Death; D006354:Heart, Artificial / Q000009:adverse effects; D006439:Hemodynamics; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D015996:Survival Rate