Replacement of the left-side valves of an implanted total artificial heart.
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.
Kamohara
Keiji
K
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Weber
Stephan
S
Klatte
Ryan S
RS
Ootaki
Yoshio
Y
Akiyama
Masatoshi
M
Kopcak
Michael W
MW
Luangphakdy
Viviane
V
Flick
Christine R
CR
Chen
Ji-Feng
JF
Navia
Jose L
JL
Smith
William A
WA
Fukamachi
Kiyotaka
K
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