This is a case report in which a goat survived for 46 days being implanted an UPTAH into her chest cavity. UPTAH is an implantable TAH developing in our laboratory in these 6 years, which is composed of 2 undulation pumps, 2 link mechanisms and 2 brushless DC motors. UPTAH has the following advantages; 1) Very compact; 75 mm in diameter and 80 mm long. 2) The right and left heart can control independently. 3) It can produce arbitrary flow pattern; continuous flow, pulsatile flow on continuous flow and complete pulsatile flow. 4) No compliance chamber is required. UPTAH was implanted into a goat chest cavity weighing 48 Kg. Under isoflurane anesthesia, the left chest was opened with fifth rib resection. Aortic cannula was attached on descending aorta with end-to-side anastomosis. The natural heart was resected under extracorporeal circulation(ECC), and atrial cuffs were sutured at the right and left atrium. The pulmonary arterial cannula was inserted into pulmonary artery and ligated. UPTAH was connected to these cannulae and atrial cuffs. The total ECC time was 124 minutes. No anticoagulant was used after the surgery. The left output was kept under complete pulsatile flow while the right one was kept pulsatile on the continuous flow. The left atrial sucking was automatically protected with computer by monitoring the left atrial pressure wave form. 1/R control in which TAH goat could control her pump output by changing her vascular resistance, was performed after 1 week. Serum free hemoglobin increased to 71 mg/dl at 24 hrs, however, it decreased to 10 mg/dl at 48 hrs. The experiment was terminated by the breaking down of the right motor cable inside the chest. At the autopsy, a large amount of ascites and congested liver were found. No thrombus was found inside the blood pump. UPTAH is the most compact TAH in the world and the experimental results shows its future practicability.
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