First report of 90-day support of 2 calves with a continuous-flow total artificial heart Jamshid H. Karimov, MD, PhD, Nader Moazami, MD, Mariko Kobayashi,

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First report of 90-day support of 2 calves with a continuous-flow total artificial heart Jamshid H. Karimov, MD, PhD, Nader Moazami, MD, Mariko Kobayashi, MD, Shiva Sale, MD, Kimberly Such, DVM, Nicole Byram, BS, Gengo Sunagawa, MD, David Horvath, MSME, Shengqiang Gao, PhD, Barry Kuban, BS, Leonard A.R. Golding, MB, BS, FRACS, Kiyotaka Fukamachi, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 150, Issue 3, Pages 687-693.e1 (September 2015) DOI: 10.1016/j.jtcvs.2015.06.023 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Schematic rendering of Cleveland Clinic continuous-flow total artificial heart pump. A, Atrial inflow and outflow configuration. B, Cross-section of the pump. OD, Outer diameter. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, The operative techniques. Both atrial stumps are reinforced with polytetrafluoroethylene strips. B, Right atrial cuff is sutured and a designated tester (*) is used to check anastomotic competence. C, All 4 (inflow and outflow) conduits are in place. D, Continuous flow total artificial heart is de-aired and connected to its inflow and outflow ports. RA, Right atrium; LA, left atrium; LOG, left outflow graft; ROG, right outflow graft; LIC, left inflow cuff; RIC, right inflow cuff. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Continuous-flow total artificial heart implant durations. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Atrial pressure differences in the 3 longest-surviving cases (ie, C15, C16, and C17). LAP, Left atrial pressure; RAP, right atrial pressure. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Hematocrit changes in the 3 longest-surviving cases (ie, C15, C16, and C17). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Calculated flow (L/min) in the 3 longest-surviving cases (ie, C15, C16, and C17). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Motor power (W) in 3 longest-surviving cases (ie, C15, C16, and C17). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Cleveland Clinic single-piece continuous-flow total artificial heart. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 687-693.e1DOI: (10.1016/j.jtcvs.2015.06.023) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions