title: Hemodynamics of a functional centrifugal-flow total artificial heart with functional atrial contraction in goats.
abstract: Implantation of a total artificial heart (TAH) is one of the therapeutic options for the treatment of patients with end-stage biventricular heart failure. There is no report on the hemodynamics of the functional centrifugal-flow TAH with functional atrial contraction (fCFTAH). We evaluated the effects of pulsatile flow by atrial contraction in acute animal models. The goats received fCFTAH that we created from two centrifugal-flow ventricular assist devices. Some hemodynamic parameters maintained acceptable levels: heart rate 115.5 ± 26.3 bpm, aortic pressure 83.5 ± 10.1 mmHg, left atrial pressure 18.0 ± 5.9 mmHg, pulmonary pressure 28.5 ± 9.7 mmHg, right atrial pressure 13.6 ± 5.2 mmHg, pump flow 4.0 ± 1.1 L/min (left) 3.9 ± 1.1 L/min (right), and cardiac index 2.13 ± 0.14 L/min/m(2). fCFTAH with atrial contraction was able to maintain the TAH circulation by forming a pulsatile flow in acute animal experiments. Taking the left and right flow rate balance using the low internal pressure loss of the VAD pumps may be easier than by other pumps having considerable internal pressure loss. We showed that the remnant atrial contraction effected the flow rate change of the centrifugal pump, and the atrial contraction waves reflected the heart rate. These results indicate that remnant atria had the possibility to preserve autonomic function in fCFTAH. We may control fCFTAH by reflecting the autonomic function, which is estimated with the flow rate change of the centrifugal pump.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan. t-shiga@med.tohoku.ac.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shiga
authors.affiliation: Department of Medical Engineering and Cardiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Sano
authors.affiliation: Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Taira
authors.affiliation: Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsuboko
authors.affiliation: Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Medical Engineering and Cardiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Katahira
authors.affiliation: Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
authors.affiliation: Department of Medical Engineering and Cardiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yambe
mesh_terms: D000818:Animals; D062185:Atrial Pressure / Q000502:physiology*; D006041:Goats; D006333:Heart Failure / Q000601:surgery; D006339:Heart Rate / Q000502:physiology*; D006354:Heart, Artificial; D006439:Hemodynamics / Q000502:physiology*; D009200:Myocardial Contraction / Q000502:physiology*; D011673:Pulsatile Flow / Q000502:physiology
keywords: Atrial contraction; Autonomic regulation; Centrifugal pump; Continuous flow; Total artificial heart