Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective
Objective: The need for safe and reliable mechanical circulatory support (MCS) for smaller children with severe heart failure (HF) is well defined. More specifically, in pediatric patients with advanced congenital HF, there is no implantable total artificial heart (TAH) device available for small pa...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250724003596 |
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| author | Jamshid H. Karimov, MD, PhD Chihiro Miyagi, MD, PhD Taiyo Kuroda, MD Anthony R. Polakowski, BS, MEng Christine R. Flick, BS Barry D. Kuban, BS Kiyotaka Fukamachi, MD, PhD Tara Karamlou, MD Munir Ahmad, MD Hani Najm, MD |
| author_facet | Jamshid H. Karimov, MD, PhD Chihiro Miyagi, MD, PhD Taiyo Kuroda, MD Anthony R. Polakowski, BS, MEng Christine R. Flick, BS Barry D. Kuban, BS Kiyotaka Fukamachi, MD, PhD Tara Karamlou, MD Munir Ahmad, MD Hani Najm, MD |
| author_sort | Jamshid H. Karimov, MD, PhD |
| collection | DOAJ |
| description | Objective: The need for safe and reliable mechanical circulatory support (MCS) for smaller children with severe heart failure (HF) is well defined. More specifically, in pediatric patients with advanced congenital HF, there is no implantable total artificial heart (TAH) device available for small patients. Herein, we report the development of the infant continuous-flow total artificial heart (I-CFTAH), a fully implantable in infants and newborns. Methods: After extensive engineering analysis, we performed an unprecedented effort: reducing the I-CFTAH's displacement volume to be 14% of the adult CFTAH pump while simultaneously decreasing pump diameter (6.2 cm to 2.6 cm) and axial length (9.8 cm to 4.8 cm). Facilitated by these proportional reductions, for the first time, a durable total artificial heart device was successfully fit in the chest of infants and newborns (height of ≥50 cm). Results: The functional I-CFTAH prototype demonstrated capability to support stable hemodynamics and desired device performance. The pump flow range (0.5-1.5 L/min) was confirmed in a mock circulatory testing loop. Within the tested flow range, the I-CFTAH can support small patients that could benefit from the intended cardiac output. Conclusions: This successful effort demonstrated the feasibility of the miniature continuous-flow total artificial heart, intended for very small patient populations. I-CFTAH showed stable hemodynamics and could, therefore, become one of the few therapeutic options as a bridge to transplantation, aiming to enhance both the quality and duration of life for pediatric patients with advanced HF. |
| format | Article |
| id | doaj-art-bc23294695a64d86b8bdc5108c8bc7e5 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-bc23294695a64d86b8bdc5108c8bc7e52025-08-20T03:36:38ZengElsevierJTCVS Techniques2666-25072024-12-012812413110.1016/j.xjtc.2024.09.001Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspectiveJamshid H. Karimov, MD, PhD0Chihiro Miyagi, MD, PhD1Taiyo Kuroda, MD2Anthony R. Polakowski, BS, MEng3Christine R. Flick, BS4Barry D. Kuban, BS5Kiyotaka Fukamachi, MD, PhD6Tara Karamlou, MD7Munir Ahmad, MD8Hani Najm, MD9Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; Kaufman Center for Heart Failure, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Address for reprints: Jamshid H. Karimov, MD, PhD, Department of Biomedical Engineering/ND20, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195.Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; Kaufman Center for Heart Failure, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OhioCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioObjective: The need for safe and reliable mechanical circulatory support (MCS) for smaller children with severe heart failure (HF) is well defined. More specifically, in pediatric patients with advanced congenital HF, there is no implantable total artificial heart (TAH) device available for small patients. Herein, we report the development of the infant continuous-flow total artificial heart (I-CFTAH), a fully implantable in infants and newborns. Methods: After extensive engineering analysis, we performed an unprecedented effort: reducing the I-CFTAH's displacement volume to be 14% of the adult CFTAH pump while simultaneously decreasing pump diameter (6.2 cm to 2.6 cm) and axial length (9.8 cm to 4.8 cm). Facilitated by these proportional reductions, for the first time, a durable total artificial heart device was successfully fit in the chest of infants and newborns (height of ≥50 cm). Results: The functional I-CFTAH prototype demonstrated capability to support stable hemodynamics and desired device performance. The pump flow range (0.5-1.5 L/min) was confirmed in a mock circulatory testing loop. Within the tested flow range, the I-CFTAH can support small patients that could benefit from the intended cardiac output. Conclusions: This successful effort demonstrated the feasibility of the miniature continuous-flow total artificial heart, intended for very small patient populations. I-CFTAH showed stable hemodynamics and could, therefore, become one of the few therapeutic options as a bridge to transplantation, aiming to enhance both the quality and duration of life for pediatric patients with advanced HF.http://www.sciencedirect.com/science/article/pii/S2666250724003596congenital heart failurepediatricmechanical circulatory supporttotal artificial heart |
| spellingShingle | Jamshid H. Karimov, MD, PhD Chihiro Miyagi, MD, PhD Taiyo Kuroda, MD Anthony R. Polakowski, BS, MEng Christine R. Flick, BS Barry D. Kuban, BS Kiyotaka Fukamachi, MD, PhD Tara Karamlou, MD Munir Ahmad, MD Hani Najm, MD Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective JTCVS Techniques congenital heart failure pediatric mechanical circulatory support total artificial heart |
| title | Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective |
| title_full | Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective |
| title_fullStr | Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective |
| title_full_unstemmed | Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective |
| title_short | Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working modelCentral MessagePerspective |
| title_sort | implantable continuous flow total artificial heart for newborns and small pediatric patients first report of working modelcentral messageperspective |
| topic | congenital heart failure pediatric mechanical circulatory support total artificial heart |
| url | http://www.sciencedirect.com/science/article/pii/S2666250724003596 |
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