title: Replacement of the left-side valves of an implanted total artificial heart.
abstract: The MagScrew total artificial heart (TAH) is under development. Despite its anticipated durability and reliability, the possibility of a bioprosthetic valve malfunction exists. As a result, the potential for valve replacement surgery, instead of device replacement, would be desirable after a TAH implant. In two of our 90-day animal experiments, we successfully replaced the left-side valves through a left thoracotomy opposite to the right-sided incision site for the initial TAH implant. The results of these cases suggest that the left-side valves could also be replaced through a left thoracotomy approach in humans. To confirm the ability to access the left-side valves in humans, four human cadaver studies were performed with the use of a mock pump designed for human application. This report describes the operative techniques for left-side valve replacement in animals and discusses the advantages of a left thoracotomy in clinical situations, based on results from the human cadaver studies.
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Keiji
authors.initials: K
authors.lastname: Kamohara
authors.forename: Stephan
authors.initials: S
authors.lastname: Weber
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Klatte
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ootaki
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kopcak
authors.forename: Viviane
authors.initials: V
authors.lastname: Luangphakdy
authors.forename: Christine R
authors.initials: CR
authors.lastname: Flick
authors.forename: Ji-Feng
authors.initials: JF
authors.lastname: Chen
authors.forename: Jose L
authors.initials: JL
authors.lastname: Navia
authors.forename: William A
authors.initials: WA
authors.lastname: Smith
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D002417:Cattle; D005240:Feasibility Studies; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006354:Heart, Artificial; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D012086:Reoperation / Q000379:methods; D013908:Thoracotomy / Q000379:methods*; D013997:Time Factors