The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Francisco A. Arabia - One of the best experts on this subject based on the ideXlab platform.
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Total Artificial Heart: PERFORMANCE AS A BRIDGE TO HEALTH AND SURVIVAL
Journal of the American College of Cardiology, 2020Co-Authors: Gaurang Vaidya, R. Cole, Francisco A. Arabia, Fardad Esmailian, Danny Ramzy, Jon A. Kobashigawa, C. Runyan, D. Megna, Dominick Emerson, Jaime MoriguchiAbstract:The performance of Total Artificial Heart (TAH) as a bridge to transplant, survival and perceived health remains underreported. Retrospective analysis of TAH patients implanted between 1/2012 and 6/2019 at a large single center. Visual analog scale (VAS) questionnaire was used during ambulatory
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Total Artificial Heart Technology: Where Are We Now?
Current Transplantation Reports, 2018Co-Authors: R. Cole, Francisco A. ArabiaAbstract:The intended goal of this paper is to review current indications, available devices, and future directions of Total Artificial Heart therapies. Throughout the paper, we sought to help clinicians identify appropriate patients who might be considered for Total Artificial Heart therapy, highlighting the most current data regarding outcomes and adverse events. The INTERMACS report on the Total Artificial Heart has recently been published in the Journal of Heart and Lung Transplantation and represents the largest study to date on available TAH therapies. Notable findings include better outcomes at experienced centers, likely a result of appropriate patient selection, timing, and management of device therapy. There are multiple new types of Total Artificial Hearts under development. Having learned from prior experience, and with increasing use and standardization of peri- and post-operative management, there is hope of ongoing success in improving care for those with advanced Heart disease and biventricular failure with the use of this technology.
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The Total Artificial Heart
Clinical Guide to Heart Transplantation, 2017Co-Authors: Francisco A. ArabiaAbstract:The Total Artificial Heart (TAH) is a replacement therapy of the Heart capable to quickly restore circulation and perfusion of the peripheral organs mainly in patients suffering for INTERMACS I/II biventricular Heart failure or for pathologies not amenable of surgical correction and requiring urgent Heart replacement. In such patients, prompt implantation of TAH is capable to provide optimal cardiac output decongesting the venous system more effectively than any other MCS strategy and with an uncommonly low incidence of technical failures and of thromboembolic and infective complications.
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Perioperative Care of the Patient With the Total Artificial Heart.
Anesthesia and analgesia, 2017Co-Authors: Jill Yaung, Francisco A. Arabia, Michael NurokAbstract:Advanced Heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The Total Artificial Heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the Total Artificial Heart with emphasis on the postoperative concerns.
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THE Total Artificial Heart: AN EFFECTIVE BRIDGE TO TRANSPLANTATION IN PATIENTS WITH ADVANCED Heart FAILURE
Journal of the American College of Cardiology, 2014Co-Authors: Swaminatha V. Gurudevan, Francisco A. Arabia, Fardad Esmailian, Danny Ramzy, Lawrence M. Czer, Jon A. Kobashigawa, Jaime MoriguchiAbstract:The Total Artificial Heart(TAH) is a self-contained mechanical circulatory device designed to temporarily support the failing Heart as a bridge to transplantation. We examined the clinical outcomes of the first 22 patients treated with the Total Artificial Heart at Cedars-Sinai. 22 patients with
Jack G. Copeland - One of the best experts on this subject based on the ideXlab platform.
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Experience with more than 100 Total Artificial Heart implants.
The Journal of thoracic and cardiovascular surgery, 2012Co-Authors: Jack G. Copeland, Richard G. Smith, Hannah Copeland, Monica Gustafson, Nicole Mineburg, Diane Covington, Mark FriedmanAbstract:Objective The SynCardia Total Artificial Heart (SynCardia Systems Inc, Tucson, Ariz) has been used as a bridge to cardiac transplantation in 930 patients worldwide and in 101 patients in our program. Our experience with SynCardia Total Artificial Heart implantation documents its indications, safety, and efficacy. Methods Data regarding preoperative condition, mortality, and morbidity have been reviewed and analyzed. Results From January 1993 to December 2009, 101 patients had bridge to transplant procedures with the SynCardia Total Artificial Heart. Ninety-one percent of cases were Interagency Registry for Mechanically Assisted Circulatory Support profile 1, and the remaining 9% of cases were failing medical therapy on multiple inotropic medications. The mean support time was 87 days (median, 53 days; range, 1–441 days). Pump outputs during support were 7 to 9 L/min. Adverse events included strokes in 7.9% of cases and take-back for hemorrhage in 24.7% of cases. Survival to transplantation was 68.3%. Causes of death of 32 patients on device support included multiple organ failure (13), pulmonary failure (6), and neurologic injury (4). Survival after transplantation at 1, 5, and 10 years was 76.8%, 60.5%, and 41.2%, respectively. The longest-term survivor is currently alive 16.4 years postimplantation. Conclusions These patients were not candidates for left ventricular assist device therapy and were expected to die. The SynCardia Total Artificial Heart offers a real alternative for survival with a reasonable complication rate in appropriate candidates who otherwise might have been assigned to hospice care.
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Risk Factor Analysis for Bridge to Transplantation With the CardioWest Total Artificial Heart
The Annals of thoracic surgery, 2008Co-Authors: Jack G. Copeland, Richard G. Smith, Pei H. Tsau, Raj K. Bose, Paul E. Nolan, Marvin J SlepianAbstract:Background. Safety and efficacy studies of various mechanical circulatory support devices are important, but may not be strictly comparable. Lacking prospective randomized studies for different devices, we believe that comparison of risk factor analyses may give the surgeon a tool more powerful than current studies for matching a patient with an appropriate device. In this paper, we report risk factor profiles for bridge to transplantation with the CardioWest Total Artificial Heart and summarize reports for other devices. Methods. A multiinstitutional risk factor analysis of the CardioWest Total Artificial Heart, as a bridge to transplantation in 81 patients, was conducted. Univariate analyses were performed on 43 preimplantation prognostic factors. From this group, eight factors were chosen for multivariate analysis. Our results were compared with all recent risk factor analyses for other devices. Results. Independent predictors for death at three intervals by multivariate analysis were as follows: “implant to transplant”: history of smoking (odds ratio, 34); “implant to 30 days after transplant”: history of smoking (odds ratio, 10.00), prothrombin time greater than 16 seconds (odds ratio, 4.76); and “implant to 1 year after transplant”: prothrombin time greater than 16 seconds (odds ratio, 3.85). The major difference between this experience and multiple reported experiences with left ventricular assist devices is that for left ventricular assist devices, but not for the temporary CardioWest Total Artificial Heart, right Heart failure, high central venous pressure, and being on a ventilator (with or without sepsis) were independent predictors of mortality. Conclusions. Risk factors for bridge to transplantation with the CardioWest Total Artificial Heart are different from those reported for left ventricular assist devices. Recognition of these risk factor differences may facilitate appropriate device selection. (Ann Thorac Surg 2008;85:1639 ‐ 45) © 2008 by The Society of Thoracic Surgeons
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CardioWest Total Artificial Heart in a moribund adolescent with left ventricular thrombi.
The Annals of thoracic surgery, 2005Co-Authors: M. Cristina Smith, Francisco A. Arabia, Richard G. Smith, Gulshan K. Sethi, Pei H. Tsau, Raj K. Bose, Daniel S. Woolley, Birger Rhenman, Jack G. CopelandAbstract:Bridge to transplant is a well-known strategy to enable patients with congestive Heart failure to live until transplant. A 15-year-old boy with Beckers' muscular dystrophy and cardiomyopathy was accepted for Heart transplantation. He suffered a cardiac arrest and was placed on extracorporeal membrane oxygenator. A paracorporeal biventricular assist device and a Total Artificial Heart were considered for bridge to transplant. A CardioWest Total Artificial Heart was chosen because of the patient's size. Multiple left ventricular thrombi were identified at the time of the ventriculectomy. The patient did well with the Total Artificial Heart was transplanted and discharged home. The unknown presence of significant left ventricular thrombi raises the question of outcome with a paracorporeal ventricular assist device.
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cardiac replacement with a Total Artificial Heart as a bridge to transplantation
The New England Journal of Medicine, 2004Co-Authors: Jack G. Copeland, Francisco A. Arabia, Richard G. Smith, Gulshan K. Sethi, Pei H. Tsau, Paul E. Nolan, Douglas Mcclellan, Marvin J SlepianAbstract:BACKGROUND The CardioWest Total Artificial Heart orthotopically replaces both native cardiac ventricles and all cardiac valves, thus eliminating problems commonly seen in the bridge to transplantation with left ventricular and biventricular assist devices, such as right Heart failure, valvular regurgitation, cardiac arrhythmias, ventricular clots, intraventricular communications, and low blood flows. METHODS We conducted a nonrandomized, prospective study in five centers with the use of historical controls. The purpose was to assess the safety and efficacy of the CardioWest Total Artificial Heart in transplant-eligible patients at risk for imminent death from irreversible biventricular cardiac failure. The primary end points included the rates of survival to Heart transplantation and of survival after transplantation. RESULTS Eighty-one patients received the Artificial-Heart device. The rate of survival to transplantation was 79 percent (95 percent confidence interval, 68 to 87 percent). Of the 35 control patients who met the same entry criteria but did not receive the Artificial Heart, 46 percent survived to transplantation (P<0.001). Overall, the one-year survival rate among the patients who received the Artificial Heart was 70 percent, as compared with 31 percent among the controls (P<0.001). One-year and five-year survival rates after transplantation among patients who had received a Total Artificial Heart as a bridge to transplantation were 86 and 64 percent. CONCLUSIONS Implantation of the Total Artificial Heart improved the rate of survival to cardiac transplantation and survival after transplantation. This device prevents death in critically ill patients who have irreversible biventricular failure and are candidates for cardiac transplantation.
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cardiac replacement with a Total Artificial Heart as a bridge to transplantation
The New England Journal of Medicine, 2004Co-Authors: Jack G. Copeland, Francisco A. Arabia, Richard G. Smith, Gulshan K. Sethi, Pei H. Tsau, Paul E. Nolan, Douglas Mcclellan, Marvin J SlepianAbstract:Background The CardioWest Total Artificial Heart orthotopically replaces both native cardiac ventricles and all cardiac valves, thus eliminating problems commonly seen in the bridge to transplantation with left ventricular and biventricular assist devices, such as right Heart failure, valvular regurgitation, cardiac arrhythmias, ventricular clots, intraventricular communications, and low blood flows. Methods We conducted a nonrandomized, prospective study in five centers with the use of historical controls. The purpose was to assess the safety and efficacy of the CardioWest Total Artificial Heart in transplant-eligible patients at risk for imminent death from irreversible biventricular cardiac failure. The primary end points included the rates of survival to Heart transplantation and of survival after transplantation. Results Eighty-one patients received the Artificial-Heart device. The rate of survival to transplantation was 79 percent (95 percent confidence interval, 68 to 87 percent). Of the 35 control...
Richard G. Smith - One of the best experts on this subject based on the ideXlab platform.
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Total Artificial Heart implantation in a young Marfan syndrome patient
The International journal of artificial organs, 2018Co-Authors: Prashant Rao, Richard G. Smith, Jack B. Keenan, Taufiek Konrad Rajab, Samuel Kim, Orazio Amabile, Zain KhalpeyAbstract:INTRODUCTION Cardiovascular complications represent the leading cause of morbidity and mortality in patients with Marfan syndrome. Here, we describe a unique case where a Total Artificial Heart was implanted in a young Marfan syndrome woman. METHODS A 22-year-old postpartum African American female with Marfan syndrome developed multiple severe valve dysfunction and biventricular failure that was refractory to medical management. She previously had a Bentall procedure for Type A aortic dissection and repair of a Type B dissection. RESULTS We implanted a Total Artificial Heart with a good outcome. CONCLUSION Total Artificial Heart is a durable option for severe biventricular failure and multiple valvular dysfunction as a bridge to transplant in a young patient with Marfan syndrome.
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Experience with more than 100 Total Artificial Heart implants.
The Journal of thoracic and cardiovascular surgery, 2012Co-Authors: Jack G. Copeland, Richard G. Smith, Hannah Copeland, Monica Gustafson, Nicole Mineburg, Diane Covington, Mark FriedmanAbstract:Objective The SynCardia Total Artificial Heart (SynCardia Systems Inc, Tucson, Ariz) has been used as a bridge to cardiac transplantation in 930 patients worldwide and in 101 patients in our program. Our experience with SynCardia Total Artificial Heart implantation documents its indications, safety, and efficacy. Methods Data regarding preoperative condition, mortality, and morbidity have been reviewed and analyzed. Results From January 1993 to December 2009, 101 patients had bridge to transplant procedures with the SynCardia Total Artificial Heart. Ninety-one percent of cases were Interagency Registry for Mechanically Assisted Circulatory Support profile 1, and the remaining 9% of cases were failing medical therapy on multiple inotropic medications. The mean support time was 87 days (median, 53 days; range, 1–441 days). Pump outputs during support were 7 to 9 L/min. Adverse events included strokes in 7.9% of cases and take-back for hemorrhage in 24.7% of cases. Survival to transplantation was 68.3%. Causes of death of 32 patients on device support included multiple organ failure (13), pulmonary failure (6), and neurologic injury (4). Survival after transplantation at 1, 5, and 10 years was 76.8%, 60.5%, and 41.2%, respectively. The longest-term survivor is currently alive 16.4 years postimplantation. Conclusions These patients were not candidates for left ventricular assist device therapy and were expected to die. The SynCardia Total Artificial Heart offers a real alternative for survival with a reasonable complication rate in appropriate candidates who otherwise might have been assigned to hospice care.
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Risk Factor Analysis for Bridge to Transplantation With the CardioWest Total Artificial Heart
The Annals of thoracic surgery, 2008Co-Authors: Jack G. Copeland, Richard G. Smith, Pei H. Tsau, Raj K. Bose, Paul E. Nolan, Marvin J SlepianAbstract:Background. Safety and efficacy studies of various mechanical circulatory support devices are important, but may not be strictly comparable. Lacking prospective randomized studies for different devices, we believe that comparison of risk factor analyses may give the surgeon a tool more powerful than current studies for matching a patient with an appropriate device. In this paper, we report risk factor profiles for bridge to transplantation with the CardioWest Total Artificial Heart and summarize reports for other devices. Methods. A multiinstitutional risk factor analysis of the CardioWest Total Artificial Heart, as a bridge to transplantation in 81 patients, was conducted. Univariate analyses were performed on 43 preimplantation prognostic factors. From this group, eight factors were chosen for multivariate analysis. Our results were compared with all recent risk factor analyses for other devices. Results. Independent predictors for death at three intervals by multivariate analysis were as follows: “implant to transplant”: history of smoking (odds ratio, 34); “implant to 30 days after transplant”: history of smoking (odds ratio, 10.00), prothrombin time greater than 16 seconds (odds ratio, 4.76); and “implant to 1 year after transplant”: prothrombin time greater than 16 seconds (odds ratio, 3.85). The major difference between this experience and multiple reported experiences with left ventricular assist devices is that for left ventricular assist devices, but not for the temporary CardioWest Total Artificial Heart, right Heart failure, high central venous pressure, and being on a ventilator (with or without sepsis) were independent predictors of mortality. Conclusions. Risk factors for bridge to transplantation with the CardioWest Total Artificial Heart are different from those reported for left ventricular assist devices. Recognition of these risk factor differences may facilitate appropriate device selection. (Ann Thorac Surg 2008;85:1639 ‐ 45) © 2008 by The Society of Thoracic Surgeons
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CardioWest Total Artificial Heart in a moribund adolescent with left ventricular thrombi.
The Annals of thoracic surgery, 2005Co-Authors: M. Cristina Smith, Francisco A. Arabia, Richard G. Smith, Gulshan K. Sethi, Pei H. Tsau, Raj K. Bose, Daniel S. Woolley, Birger Rhenman, Jack G. CopelandAbstract:Bridge to transplant is a well-known strategy to enable patients with congestive Heart failure to live until transplant. A 15-year-old boy with Beckers' muscular dystrophy and cardiomyopathy was accepted for Heart transplantation. He suffered a cardiac arrest and was placed on extracorporeal membrane oxygenator. A paracorporeal biventricular assist device and a Total Artificial Heart were considered for bridge to transplant. A CardioWest Total Artificial Heart was chosen because of the patient's size. Multiple left ventricular thrombi were identified at the time of the ventriculectomy. The patient did well with the Total Artificial Heart was transplanted and discharged home. The unknown presence of significant left ventricular thrombi raises the question of outcome with a paracorporeal ventricular assist device.
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cardiac replacement with a Total Artificial Heart as a bridge to transplantation
The New England Journal of Medicine, 2004Co-Authors: Jack G. Copeland, Francisco A. Arabia, Richard G. Smith, Gulshan K. Sethi, Pei H. Tsau, Paul E. Nolan, Douglas Mcclellan, Marvin J SlepianAbstract:BACKGROUND The CardioWest Total Artificial Heart orthotopically replaces both native cardiac ventricles and all cardiac valves, thus eliminating problems commonly seen in the bridge to transplantation with left ventricular and biventricular assist devices, such as right Heart failure, valvular regurgitation, cardiac arrhythmias, ventricular clots, intraventricular communications, and low blood flows. METHODS We conducted a nonrandomized, prospective study in five centers with the use of historical controls. The purpose was to assess the safety and efficacy of the CardioWest Total Artificial Heart in transplant-eligible patients at risk for imminent death from irreversible biventricular cardiac failure. The primary end points included the rates of survival to Heart transplantation and of survival after transplantation. RESULTS Eighty-one patients received the Artificial-Heart device. The rate of survival to transplantation was 79 percent (95 percent confidence interval, 68 to 87 percent). Of the 35 control patients who met the same entry criteria but did not receive the Artificial Heart, 46 percent survived to transplantation (P<0.001). Overall, the one-year survival rate among the patients who received the Artificial Heart was 70 percent, as compared with 31 percent among the controls (P<0.001). One-year and five-year survival rates after transplantation among patients who had received a Total Artificial Heart as a bridge to transplantation were 86 and 64 percent. CONCLUSIONS Implantation of the Total Artificial Heart improved the rate of survival to cardiac transplantation and survival after transplantation. This device prevents death in critically ill patients who have irreversible biventricular failure and are candidates for cardiac transplantation.
Takashi Isoyama - One of the best experts on this subject based on the ideXlab platform.
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Third model of the undulation pump Total Artificial Heart.
ASAIO journal (American Society for Artificial Internal Organs : 1992), 2003Co-Authors: Yusuke Abe, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Shuichi Mochizuki, Itsuro Saito, Kiyotaka Iwasaki, M. Ishimaru, Atsushi Baba, Akimasa KounoAbstract:The undulation pump is a small, continuous flow displacement type blood pump, and the undulation pump Total Artificial Heart (UPTAH) is a unique, implantable Total Artificial Heart based on this pump. To improve the durability of the UPTAH for investigating long-term pathophysiology with UPTAH, a third model (UPTAH3) has been developed. UPTAH3 was designed to separate the left and right undulation shafts and to be more durable. The undulation pumps were also redesigned. UPTAH3 was implemented with a diameter of 76 mm, width of 78 or 79 mm, Total volume of 292 ml, and weight of 620 g. The priming volumes of the left and right pumps are 26 and 21 ml, respectively. The atrial cuffs and outflow cannulae were also redesigned for UPTAH3. The maximum output against an arterial pressure load of 100 mm Hg is about 11 L/min. The maximum pump efficiency is about 15% in the left pump and 18% in the right pump, giving a maximum Total efficiency for both of about 11 %. To date, UPTAH3 has been tested in 17 goats, and the longest survival period was 46 days. This third model will be useful for investigating pathophysiology with UPTAH.
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Pathophysiologic study of goats with undulation pump Total Artificial Heart: those that survived for more than 1 month.
ASAIO journal (American Society for Artificial Internal Organs : 1992), 2003Co-Authors: Atsushi Baba, Takashi Isoyama, Yusuke Abe, Itsuro Saito, M. Ishimaru, Jaromir Vasku, Petr Dobšák, Koki Takiura, Toshinaga Ozeki, Tsuneo ChinzeiAbstract:The undulation pump Total Artificial Heart is an implantable Total Artificial Heart that is being developed at the University of Tokyo. Many advances in our system have been made by the adoption of hardware and software solutions that enabled the animals with the undulation pump Total Artificial Hearts to survive more than 1 month. Pathophysiologic observations were performed for these goats that survived. In this article, the pathophysiologic findings are described in detail for three goats that survived for 46 ( goat 9916), 54 (0030), and 63 (0107) days. The microscopic findings indicated that in goat 0107 the histologic changes in key organs occurred at the termination of the experiments. Therefore, the pathophysiologic changes in goats 9916 and 0030 were mainly investigated in this study to evaluate the chronic effect caused by our Total Artificial Heart system. The signs of chronic ischemia and cell dystrophy were observed in both the liver and kidney. Until now, 13 goats had survived more than 1 week and 6 goats survived more than 1 month, including one that survived for 63 days, which is the longest in our experimental series. The pathophysiologic results of goats 9916 and 0030 showed that the undulation pump Total Artificial Heart might still cause some damage to the liver and the kidney. To accomplish long-term survival with the undulation pump Total Artificial Heart, further pathophysiologic studies are required, and the necessary modifications to the Total Artificial Heart system will need to be made.
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Progress in the Control System of the Undulation Pump Total Artificial Heart
Artificial organs, 2003Co-Authors: Itsuro Saito, Takashi Isoyama, Tsuneo Chinzei, Akimasa Kouno, Toshiya Ono, Yusuke Abe, Shuichi Mochizuki, Kiyotaka Iwasaki, M. Ishimaru, Atsushi BabaAbstract:The undulation pump Total Artificial Heart (UPTAH) is a small implantable Total Artificial Heart. As the UPTAH generates outflow and inflow at the same time, control of the UPTAH is very difficult. Therefore suitable control methods specifically for the UPTAH should be established. Various motor control, left-right flow balance control, and physiological control methods were examined and tried for the UPTAH control in this study. The control system is divided into seven categories. It has a hierarchical structure and all control modes work at the same time. The UPTAH with the newly developed control method has been implanted into the chest cavities of 48 goats. Until now, six goats survived for more than one month, including 63 days in the longest case. The good condition of the UPTAH implanted animal could be maintained with the newly developed control scheme, consisting of the 1/R control and several other additional controls.
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A step forward for the undulation pump Total Artificial Heart
Journal of Artificial Organs, 2000Co-Authors: Yusuke Abe, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Shuichi Mochizuki, Itsuro Saito, Kiyotaka Iwasaki, M. Ishimaru, Atsushi Baba, Akimasa KounoAbstract:In the University of Tokyo, various types of Total Artificial Heart (TAH) have been studied. Based on the experiences of TAH research, the development of the undulation pump Total artifical Heart (UPTAH) started in 1994. The undulation pump is a small-size, continuous-flow, displacement-type blood pump, and the UPTAH is a unique implantable Total Artificial Heart that uses the undulation pump. To date, three models of UPTAH have been developed. The first model, UPTAH1, was developed to investigate the possibility of reducing the size of the device so it could be implanted in small adults, such as Japanese patients, in 1994. The second model, UPTAH2, which was the prototype of the animal experimental model, was developed in 1996 to investigate the possibility of survival with the UPTAH. The third model, UPTAH3, which is the present model, was developed in 1998 to enable long-term survival in animal experiments and to investigate the pathophysiology of the UPTAH. From July 1996 to October 1999, 22 implantations of UPTAH2 or UPTAH3 were performed in goats. In spite of the limitation of their small chest cavity, the UPTAH could be implanted into the chest of all goats. Using UPTAH3, survival of 31 days could be obtained. The research and development of UPTAH are ongoing.
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Implantable Total Artificial Heart: history and present status at the University of Tokyo
Journal of Artificial Organs, 1999Co-Authors: Kou Imachi, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Yusuke Abe, Shuichi Mochizuki, Itsuro Saito, Tatsuo Karita, Hiroyuki Matsuura, Akimasa KounoAbstract:The University of Tokyo has been involved in research and development of the Artificial Heart since 1959. This paper is a brief review of 40 years of Total Artificial Heart research in the University of Tokyo. Many types of Artificial Heart and various kinds of materials, blood pumps, valves, drive units, control methods, and pathophysiology have been investigated in our original fashion. The longest survival was 532 days for a goat with a Total Artificial Heart (TAH) placed on the chest wall. These results made us take a step toward the development of an implantable TAH. Two kinds of implantable TAH are now being developed: FTPTAH (flow-transformed pulsatile Total Artificial Heart) and UPTAH (undulation pump Total Artificial Heart). Recently, a goat survived for 31 days with an UPTAH.
Toshiya Ono - One of the best experts on this subject based on the ideXlab platform.
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Third model of the undulation pump Total Artificial Heart.
ASAIO journal (American Society for Artificial Internal Organs : 1992), 2003Co-Authors: Yusuke Abe, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Shuichi Mochizuki, Itsuro Saito, Kiyotaka Iwasaki, M. Ishimaru, Atsushi Baba, Akimasa KounoAbstract:The undulation pump is a small, continuous flow displacement type blood pump, and the undulation pump Total Artificial Heart (UPTAH) is a unique, implantable Total Artificial Heart based on this pump. To improve the durability of the UPTAH for investigating long-term pathophysiology with UPTAH, a third model (UPTAH3) has been developed. UPTAH3 was designed to separate the left and right undulation shafts and to be more durable. The undulation pumps were also redesigned. UPTAH3 was implemented with a diameter of 76 mm, width of 78 or 79 mm, Total volume of 292 ml, and weight of 620 g. The priming volumes of the left and right pumps are 26 and 21 ml, respectively. The atrial cuffs and outflow cannulae were also redesigned for UPTAH3. The maximum output against an arterial pressure load of 100 mm Hg is about 11 L/min. The maximum pump efficiency is about 15% in the left pump and 18% in the right pump, giving a maximum Total efficiency for both of about 11 %. To date, UPTAH3 has been tested in 17 goats, and the longest survival period was 46 days. This third model will be useful for investigating pathophysiology with UPTAH.
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Progress in the Control System of the Undulation Pump Total Artificial Heart
Artificial organs, 2003Co-Authors: Itsuro Saito, Takashi Isoyama, Tsuneo Chinzei, Akimasa Kouno, Toshiya Ono, Yusuke Abe, Shuichi Mochizuki, Kiyotaka Iwasaki, M. Ishimaru, Atsushi BabaAbstract:The undulation pump Total Artificial Heart (UPTAH) is a small implantable Total Artificial Heart. As the UPTAH generates outflow and inflow at the same time, control of the UPTAH is very difficult. Therefore suitable control methods specifically for the UPTAH should be established. Various motor control, left-right flow balance control, and physiological control methods were examined and tried for the UPTAH control in this study. The control system is divided into seven categories. It has a hierarchical structure and all control modes work at the same time. The UPTAH with the newly developed control method has been implanted into the chest cavities of 48 goats. Until now, six goats survived for more than one month, including 63 days in the longest case. The good condition of the UPTAH implanted animal could be maintained with the newly developed control scheme, consisting of the 1/R control and several other additional controls.
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A step forward for the undulation pump Total Artificial Heart
Journal of Artificial Organs, 2000Co-Authors: Yusuke Abe, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Shuichi Mochizuki, Itsuro Saito, Kiyotaka Iwasaki, M. Ishimaru, Atsushi Baba, Akimasa KounoAbstract:In the University of Tokyo, various types of Total Artificial Heart (TAH) have been studied. Based on the experiences of TAH research, the development of the undulation pump Total artifical Heart (UPTAH) started in 1994. The undulation pump is a small-size, continuous-flow, displacement-type blood pump, and the UPTAH is a unique implantable Total Artificial Heart that uses the undulation pump. To date, three models of UPTAH have been developed. The first model, UPTAH1, was developed to investigate the possibility of reducing the size of the device so it could be implanted in small adults, such as Japanese patients, in 1994. The second model, UPTAH2, which was the prototype of the animal experimental model, was developed in 1996 to investigate the possibility of survival with the UPTAH. The third model, UPTAH3, which is the present model, was developed in 1998 to enable long-term survival in animal experiments and to investigate the pathophysiology of the UPTAH. From July 1996 to October 1999, 22 implantations of UPTAH2 or UPTAH3 were performed in goats. In spite of the limitation of their small chest cavity, the UPTAH could be implanted into the chest of all goats. Using UPTAH3, survival of 31 days could be obtained. The research and development of UPTAH are ongoing.
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Implantable Total Artificial Heart: history and present status at the University of Tokyo
Journal of Artificial Organs, 1999Co-Authors: Kou Imachi, Takashi Isoyama, Tsuneo Chinzei, Toshiya Ono, Yusuke Abe, Shuichi Mochizuki, Itsuro Saito, Tatsuo Karita, Hiroyuki Matsuura, Akimasa KounoAbstract:The University of Tokyo has been involved in research and development of the Artificial Heart since 1959. This paper is a brief review of 40 years of Total Artificial Heart research in the University of Tokyo. Many types of Artificial Heart and various kinds of materials, blood pumps, valves, drive units, control methods, and pathophysiology have been investigated in our original fashion. The longest survival was 532 days for a goat with a Total Artificial Heart (TAH) placed on the chest wall. These results made us take a step toward the development of an implantable TAH. Two kinds of implantable TAH are now being developed: FTPTAH (flow-transformed pulsatile Total Artificial Heart) and UPTAH (undulation pump Total Artificial Heart). Recently, a goat survived for 31 days with an UPTAH.
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Implantation of the undulation pump Total Artificial Heart in the goat.
Artificial organs, 1999Co-Authors: Yusuke Abe, Tsuneo Chinzei, Akimasa Kouno, Toshiya Ono, Shuichi Mochizuki, Itsuro Saito, P Guba, Tatsuro Karita, Y P Sun, Takashi IsoyamaAbstract:The undulation pump Total Artificial Heart (UPTAH) was developed by using small-size continuous-flow displacement-type blood pumps (undulation pump). To clarify and improve the problems accompanied by the implantation in the chest, 14 animal experiments were performed on goats weighing 41.3-79.2 kg. The UPTAH could be implanted in the chest of all goats and was driven with a modulation pulsatile mode. The first problem was the atrial suction effect. This problem could be prevented to some extent by developing the soft disk and by improving atrial cuffs. An automatic detection and releasing of the atrial suction effect was also tried. The next problem was acute lung edema accompanied by the postural change of the animal. Development of the automatic control of left atrial pressure could prevent this problem. Small blood leakage from a pinpoint hole in the seal membrane was the next problem. Improvement of the manufacturing procedure of the membrane prevented this. With these improvements, a 10 day survival could be obtained with this unique implantable Total Artificial Heart.
