Magscrew Total Artificial Heart In Vivo Performance Above 200 Beats Per Minute Soren Schenk, MD, Stephan Weber, Dipl Ing, Viviane Luangphakdy, MSBME,

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Magscrew Total Artificial Heart In Vivo Performance Above 200 Beats Per Minute Soren Schenk, MD, Stephan Weber, Dipl Ing, Viviane Luangphakdy, MSBME, Ryan S. Klatte, BSBME, Christine R. Flick, BSBME, Ji- Feng Chen, BS, Michael W. Kopcak, BA, Yoshio Ootaki, MD, PhD, Keiji Kamohara, MD, Gordon B. Hirschman, MEng EE, Nicholas G. Vitale, BSME, Peter A. Chapman, BSME PE, William A. Smith, D Eng PE, Kiyotaka Fukamachi, MD, PhD The Annals of Thoracic Surgery Volume 79, Issue 4, Pages 1378-1383 (April 2005) DOI: 10.1016/j.athoracsur.2004.03.064

Fig 1 MagScrew total artificial heart (TAH). (A, B) The actuation mechanism is based on the attracting forces of conventional magnets incorporated in “MagScrew” and “MagNut.” The motor/MagNut combination alternately rotates clockwise and counterclockwise. The linear bearing of the MagScrew forces the MagScrew to reciprocate to maintain alignment of the magnetic “threads” with the nut. This alternately pushes the right and left pump to ejection. (C) Device configuration in a potential human implant. The full system includes the MagScrew TAH and supporting devices (ie, electronic control unit, compliance chamber with refill port, internal and external batteries, and a transcutaneous energy transmission system [TETS]). The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 2 Flow generation versus beat rate. The linear relationship between device flow and beat rate indicates adequate fill up to 250 beats per minute (bpm) in vivo (closed circles) and 270 bpm in vitro (open circles). The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 3 In vivo controller response. Five episodes of decreasing left atrial pressure (LAP) are identified (arrows), which mark device beat rate adjustments. Corresponding trends of flow are demonstrated. The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 4 In vitro preload sensitivity. The device response at various preload conditions (left atrial pressure [LAP]) was tested under a wide range of afterload conditions [aortic pressure (AoP) 70–130 mm Hg; pulmonary artery pressure (PAP) 20–40 mm Hg]). All pressures represent mean values. The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 5 In vivo atrial balance. (LAP = left atrial pressure; RAP = right atrial pressure). The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 6 In vivo aortic pulse pressure and pulsatility index versus device beat rate (beats per minute [bpm]). The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)

Fig 7 Comparison of aortic pulse pressure (AoP) waveforms of the native heart (A) and the MagScrew total artificial heart (B). The Annals of Thoracic Surgery 2005 79, 1378-1383DOI: (10.1016/j.athoracsur.2004.03.064)