Modifications in surgical implantation of the Penn State electric total artificial heart

Background. Two modifications of the surgical implantation protocol for the Penn State Total Artificial Heart (ETAH) were evaluated: Phrenic nerve isc hemia was prevented by minimizing dissection and traction; and hemostasis w as augmented and ETAH cuff anastomoses reinforced by using fibrin glue. Methods. Thirteen Holstein calves underwent orthotopic surgical implantatio n of the Penn State ETAH between February 1998 and August 2000. Mean hemody namic and laboratory chemistry variables from the first postoperative week were compared between calves receiving the original (n = 7) and modified (n = 6) protocol. Results. Calves assigned to the modified protocol displayed an improvement in the PO2/FiO(2) ratio compared to original (419.4 +/- 17.5 vs 336.3 +/- 3 5.4, respectively; p = 0.05). All additional parameters were equivalent bet ween groups. The percent survival of animals receiving the modified protoco l at 2, 4, and 12 weeks was higher than that of animals that underwent the original protocol. Original-protocol calf deaths consisting of hemothorax ( n = 3), and respiratory failure (n = 1) were prevented in the modified prot ocol. Conclusions. Our results suggest that manipulations in surgical protocol ma y promote increased survival in calves implanted with the Penn State ETAH. (C) 2001 by The Society of Thoracic Surgeons.