Initial experience with the AbioCor implantable replacement heart at the University of Louisville

Potential benefits of heart transplantation are limited by the severe donor organ shortage. The AbioCor implantable replacement heart has been develop ed as a potential alternative to heart transplantation. We report our initi al experience with the AbioCor in a bovine model. A right thoracotomy was p erformed for access to the heart and great vessels. After initiation of car diopulmonary bypass, excision of the native ventricles was followed by orth otopic placement of the IRH and complete implantation of the transcutaneous energy transfer coil, controller, and battery pack. Invasive monitoring of IVC, SVC, carotid artery, pulmonary artery, and left atrial (LA) pressures was performed in all animals. Twelve calves have undergone implantation of the AbioCor. There were three early deaths, one from bleeding, one from re spiratory failure, and one from neurodysfunction from low flow during CPB. Nine animals have had a normal recovery and survived a mean of 24.5 days (r ange, 4-48 days). All the animals have demonstrated excellent hemodynamics with the maintenance of normal pressures in the LA, SVC, IVC, pulmonary art ery, and aorta. Adjustment of the right-sided internal hydraulic fluid shun t has allowed for control of right-left balance and, thereby, manipulation of left and right side filling pressures. Late morbidity has consisted of n eck wound infection and sepsis, pneumonia, and bleeding. Successful orthoto pic implantation of all components of the AbioCor has been achieved in a bo vine model. This device has demonstrated restoration of normal hemodynamics and excellent function of the atrial hydraulic shunt to achieve right-left balance.