Abstract
The ultimate goal of total artificial heart is permanent substitute for a failed heart in a patient without any other therapeutic modality. Until now, infection has been the main problem related to the mechanical circulatory support system. The best way to solve this catastrophic complication and to improve the quality of life of TAH patients in terms of tethering must be implantation of TAH totally. The EH-TAH has been developed in NCVC from 1987 for this purpose. The system consists of an energy converter and pumps, which are designed to be placed in abdomen and pericardial space separately for a good anatomical fit. To evaluate the anatomical fit and hemodynamic performance of the EH-TAH, in vivo test was done. General condition of the animal and hemodynamic status had been stable until the TAH stopped on the 11th pumping day. The estimated cardiac output was about 7.7L/min. The values of mean aortic pressure, left and right atrial pressure were 93$\pm$10, 19$\pm$3 and 15$\pm$4 mmHg, respectively. The correlation coefficient between left and right atrial pressure was 0.96, which represents the dynamic function of the interatrial shunt in controlling left-right imbalance of cardiac output. During pumping days, the temperature on the surface of actuator had been maintained at 39.7$\pm$0.4$^{\circ}C$, less than 1$^{\circ}C$ higher than the rectal temperature. The TAH stopped on the 11th day due to mechanical problems. We concluded that the EH-TAH possessed satisfactory basic performance including anatomic fit and hemodynamic adequacy, although there were several mechanical problems to be solved yet.
인공심장의 주된 합병증인 혈전과 감염의 문제를 줄이고 장착 환자의 삶의 질을 높이기 위하여 체내 완전 매립형 전기 유압식 인공심장을 개발하고 있는 것과 이 모델을 이용한 동물실험에 대하여 보고하는 바이다. 이 인공심장은 혈액펌프, 유압구동기, 구동제어회로, 경피적 에너지-정보 전송시스템, 체내 받테리 등으로 구성되어 있다. 실험동물은 체중 62Kg의 송아지를 이용하였다. 흉강내 이식하는데 어려움은 없었고, 수술 후 생존하는 동안 혈역학적으로 문제는 없었으며 특이한 합병증도 발생하지 않았다. 그러나 이식 11일째 기계적인 결함으로 작동이 정지하였다. 앞으로 기계적 수명이나 생체적 합성 등의 문제 등히 해결되어야 할 것이다.