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Pulmonary Pressure Assessment with the Total Artificial Heart

Joyce, David L.*; Redfield, Margaret M.; Kushwaha, Sudhir S.; Behfar, Atta†‡; Borlaug, Barry A.; Daly, Richard C.*; Sandhu, Gurpreet S.†‡; Joyce, Lyle D.*

doi: 10.1097/MAT.0000000000000632
Case Series: PDF Only

Reversal of pulmonary hypertension has been observed in patients during a bridge to transplant with a left ventricular assist device. Total artificial heart (TAH) implant prevents subsequent right heart catheterization. Consequently, controversy exists over whether the prosthetic right ventricle improves or exacerbates pulmonary hypertension. A pulmonary artery (PA) pressure monitor was placed in two patients undergoing TAH implant, as a bridge to transplant. One patient had pulmonary hypertension at implant; the other had normal pulmonary pressures. Daily measurements were taken of systolic, diastolic, and mean PA pressures throughout support. Patient 1 received successful transplant after TAH support of 91 days. Systolic/diastolic (mean) PA pressures steadily decreased from 55/39 (28) mm Hg at implant to 29/18 (7) mm Hg currently. Patient 2 received support for 101 days before death due to abdominal ischemic complications. Pulmonary arterial pressures stayed consistent throughout this period, from 26/17 (20) mm Hg at implant to 23/13 (17) mm Hg at the time of death. These findings suggest that an implantable PA pressure monitor may be useful in optimizing hemodynamics and planning appropriate timing of transplant with TAH support.

From the *Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota; Division of Cardiovascular, Mayo Clinic, Rochester, Minnesota; and Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota.

Submitted for consideration September 2016; accepted for publication in revised form June 2017.

Disclosure: The authors have no conflicts of interest to report.

Mayo Clinic does not endorse specific products or services discussed in this article.

Presented as a podium presentation at the ASAIO 62nd Annual Conference; June 15–18, 2016; San Francisco, CA.

Correspondence: David L. Joyce, Division of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905. Email:

Copyright © 2018 by the American Society for Artificial Internal Organs