Total Artificial Heart (TAH) development at Penn State University and 3M Health Care has progressed from design improvements and manufacturing documentation to in vitro and in vivo testing to characterize the system's hemodynamic response and energetic performance. The TAH system is completely implantable and intended for use as an alternative to transplantation. It includes a dual pusher plate pump and rollerscrew actuator, welded electronics and battery assembly, transcutaneous energy transmission system, telemetry, and a compliance chamber. In vitro testing was conducted on a Penn State mock circulatory loop with glycerol/water solution at body temperature. Tests were performed to characterize the preload and afterload response, left atrial pressure control, and power consumption. A sensitive preload response was demonstrated with left atrial pressure safely maintained at less than 15 mm Hg for flow rates up to 7.5 L/min. Variations in aortic pressure and pulmonary vascular resistance were found to have minimal effects on the preload sensitivity and left atrial pressure control. In vivo testing of the completely implanted system in its final configuration was carried out in two acute studies using implanted temperature sensors mounted on the electronics, motor, and energy transmission coil in contact with adjacent tissue. The mean temperature at the device-tissue interface was less than 4 degrees C above core temperature.
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http://dx.doi.org/10.1097/00002480-199905000-00016 | DOI Listing |
Ann Thorac Surg Short Rep
September 2023
Division of Cardiovascular Surgery, University of Florida Health, Gainesville, Florida.
Convergent hybrid atrial fibrillation ablation combines epicardial posterior left atrial ablation with catheter pulmonary vein isolation. Concomitant left atrial appendage AtriClip placement has recently been included to mitigate stroke risk. We describe a 72-year-old woman with long-standing persistent atrial fibrillation in whom atrial flutter with reentry encircling the AtriClip developed 18 months after a successful convergent procedure.
View Article and Find Full Text PDFEur J Case Rep Intern Med
December 2024
Internal Medicine, Holy Family Hospital, Rawalpindi, Pakistan.
Background: Andersen-Tawil syndrome (ATS) is a rare autosomal dominant disorder caused by variants in the gene. It is associated with periodic paralysis, dysmorphic features and cardiac arrhythmias. The syndrome exhibits incomplete penetrance, leading to a broad spectrum of clinical manifestations, making diagnosis challenging.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2023
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
A 72-year-old woman presented with dyspnea 2 years after mitral valve replacement with a 25-mm Epic bioprosthesis. Exercise echocardiography revealed a mean transvalvular gradient of 16 mm Hg, consistent with functional mitral stenosis due to prosthesis-patient mismatch. Because of the anticipated difficulties with insertion of a larger prosthesis, we proceeded with bypass of the mitral valve using a left atrial to left ventricular valved conduit.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2023
Department of Cardiac Surgery, Hartford HealthCare Heart and Vascular Institute, Hartford, Connecticut.
Background: Prior studies have demonstrated a lower prevalence of postoperative atrial fibrillation (POAF) in Black, Hispanic, Asian, and Native American patients compared with White cohorts after coronary artery bypass grafting. We hypothesized that preoperative differences in left atrial size may explain this disparity.
Methods: We assessed the incidence of new POAF in 1218 patients (215 minority patients and 1003 White patients) undergoing isolated, first-time coronary artery bypass grafting from January 2017 through September 2022.
Ann Thorac Surg Short Rep
December 2024
Division of Cardiac Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
A 53-year-old male individual with chronic severe mitral regurgitation presented with biventricular dysfunction, pulmonary hypertension, and atrial fibrillation. Echocardiography demonstrated a posterior leaflet prolapse with malcoaptation. Mitral valve repair and Maze procedure were performed, revealing absent chordae and direct connection from the anterolateral papillary muscle to the posterior leaflet, consistent with partial mitral arcade.
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