Clinical Management of Total Artificial Heart Drive Systems

Abstract

THE EVOLUTION of the total artificial heart (TAH) from animal experimentation to clinical research has necessitated major changes in the control of the drive equipment responsible for prosthesis function. Our experience with patients who have been permanent recipients of the heart has contributed to a refinement of the operating protocol and furthered understanding of the hemodynamic response to artificial circulation devices. <h3>PROSTHESIS DESIGN</h3> The basic design of the pneumatic TAH has changed little since early animal experimentation and still incorporates a flexible diaphragm inside a semirigid housing.^1-3In the Jarvik-7-100 (Symbion, Inc, Salt Lake City) ventricles, which constitute the device under discussion herein, polyurethane polymer (Biomer, Ethicon Inc, Somerville, NJ) is molded with Dacron polyester mesh to form the semirigid housing. Four layers of Biomer each 0.18 mm in thickness constitute the inflatable diaphragm. Graphite powder between the diaphragm layers deters creation of a flexion crease, which could lead