title: Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.
abstract: Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs.
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Banner-University Medical Center.|College of Medicine-Tucson, University of Arizona.|Department of Physiological Sciences, University of Arizona.|Department of Biomedical Engineering, University of Arizona.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ferng
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Banner-University Medical Center.|College of Medicine-Tucson, University of Arizona.|Department of Medical Imaging, Banner-University Medical Center.|Sarver Heart Center, University of Arizona.
authors.forename: Isabel
authors.initials: I
authors.lastname: Oliva
authors.affiliation: College of Medicine-Tucson, University of Arizona.|Department of Medical Imaging, Banner-University Medical Center.
authors.forename: Clinton
authors.initials: C
authors.lastname: Jokerst
authors.affiliation: College of Medicine-Tucson, University of Arizona.|Department of Medical Imaging, Banner-University Medical Center.
authors.forename: Ryan
authors.initials: R
authors.lastname: Avery
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Banner-University Medical Center.|College of Medicine-Tucson, University of Arizona.
authors.forename: Alana M
authors.initials: AM
authors.lastname: Connell
authors.affiliation: College of Medicine-Tucson, University of Arizona.|Sarver Heart Center, University of Arizona.|SynCardia Systems, Inc, Tucson, AZ, USA.
authors.forename: Phat L
authors.initials: PL
authors.lastname: Tran
authors.affiliation: Sarver Heart Center, University of Arizona.|SynCardia Systems, Inc, Tucson, AZ, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Smith
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Banner-University Medical Center.|College of Medicine-Tucson, University of Arizona.|Department of Physiological Sciences, University of Arizona.|Department of Biomedical Engineering, University of Arizona.
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006354:Heart, Artificial; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014481:United States; D055815:Young Adult
keywords: -3D surgical modeling; -Computerized tomography; -Magnetic resonance imaging; -Total artificial heart; Virtual implantation