Simplified right-left balance for the implanted artificial heart View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1991

AUTHORS

Don B. Olsen , James W. Long

ABSTRACT

It has been well established that the net output from the right side of a total artificial heart exceeds that from the left, while in reality the net flow required from the left ventricle must be greater than that from the right to accommodate the bronchial artery shunt. The historical background, physiology, and methods to accommodate this characteristic are reviewed. Right-left output disparity is inherently accommodated by pneumatic artificial hearts in which the two ventricles pump independent of each other. Because of separate autoregulation and regular venting to the atmosphere, the right and left sides remain balanced. With electrohydraulic or electromechanical artificial hearts designed for complete implantation, however, right and left ventricular functions are obligatorily linked, as stroke volumes from each side will be identical unless specifically accommodated. Failure to accommodate results in right-left imbalance leading to pathologic conditions. Compensatory mechanisms that have been described generally use volume-displacement chambers. However, this approach introduces additional space requirements, and complex engineering and surgical problems. Alternatives to volume-displacement chambers have been explored at the Artificial Heart Research Laboratory, Institute for Biomedical Engineering. The currently described approach uses an interatrial shunt to maintain balance by redistributing volume and pressure differences from one side to the other. Under normal hemodynamic conditions, net interatrial shunt flow from the left to the right atrium is less than 10% to 15% of cardiac output. The interatrial shunt maintains balance over a wide range of preload and afterload conditions. It is anticipated that use of the interatrial shunt will balance an implantable, electrohydraulic total artificial heart. This simplified approach avoids the space demands, surgical problems, and complex engineering required by more traditional approaches to right-left heart balance. More... »

PAGES

235-245

References to SciGraph publications

Book

TITLE

Artificial Heart 3

ISBN

978-4-431-68128-1
978-4-431-68126-7

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-4-431-68126-7_28

DOI

http://dx.doi.org/10.1007/978-4-431-68126-7_28

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029362986


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