Human fitting of pediatric and infant continuous-flow total artificial heart: visual and virtual assessment

• Published in: Frontiers in cardiovascular medicine Vol. 10; p. 1193800
• Main Authors: Miyagi, Chihiro, Ahmad, Munir, Karimov, Jamshid H, Polakowski, Anthony R, Karamlou, Tara, Yaman, Malek, Fukamachi, Kiyotaka, Najm, Hani K
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 17.07.2023
• Subjects: Cardiovascular Medicine; congenital heart disease; infant total artificial heart; mechanical circulatory support; pediatric heart failure; pediatric total artificial heart; infant total artificial heart; congenital heart disease; mechanical circulatory support; pediatric heart failure; pediatric total artificial heart
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2023.1193800

This study aimed to determine the fit of two small-sized (pediatric and infant) continuous-flow total artificial heart pumps (CFTAHs) in congenital heart surgery patients. This study was approved by Cleveland Clinic Institutional Review Board. Pediatric cardiac surgery patients (  = 40) were evaluated for anatomical and virtual device fitting (3D-printed models of pediatric [P-CFTAH] and infant [I-CFTAH] models). The virtual sub-study consisted of analysis of preoperative thoracic radiographs and computed tomography (  = 3; 4.2, 5.3, and 10.2 kg) imaging data. P-CFTAH pump fit in 21 out of 40 patients (fit group, 52.5%) but did not fit in 19 patients (non-fit group, 47.5%). I-CFTAH pump fit all of the 33 patients evaluated. There were critical differences due to dimensional variation (  < 0.0001) for the P-CFTAH, such as body weight (BW), height (Ht), and body surface area (BSA). The cutoff values were: BW: 5.71 kg, Ht: 59.0 cm, BSA: 0.31 m . These cutoff values were additionally confirmed to be optimal by CT imaging. This study demonstrated the range of proper fit for the P-CFTAH and I-CFTAH in congenital heart disease patients. These data suggest the feasibility of both devices for fit in the small-patient population.