Biventricular assist devices and total artificial heart: Strategies and outcomes

In contrast to the advanced development of the left ventricular assist device (LVAD) therapy for advanced heart failure, the mechanical circulatory support (MCS) with biventricular assist device (BVAD) and total artificial heart (TAH) options remain challenging. The treatment strategy of BVAD and TAH therapy largely depends on the support duration. For example, an extracorporeal centrifugal pump, typically referred to as a temporary surgical extracorporeal right ventricular assist device, is implanted for the short term with acute right ventricular failure following LVAD implantation. Meanwhile, off-label use of a durable implantable LVAD is a strategy for long-term right ventricular support. Hence, this review focuses on the current treatment strategies and clinical outcomes based on each ventricle support duration. In addition, the issue of heart failure post-heart transplantation (post-HT) is explored. We will discuss MCS therapy options for post-HT recipients

Human fitting of pediatric and infant continuous-flow total artificial heart: visual and virtual assessment

BackgroundThis study aimed to determine the fit of two small-sized (pediatric and infant) continuous-flow total artificial heart pumps (CFTAHs) in congenital heart surgery patients.MethodsThis study was approved by Cleveland Clinic Institutional Review Board. Pediatric cardiac surgery patients (n = 40) were evaluated for anatomical and virtual device fitting (3D-printed models of pediatric [P-CFTAH] and infant [I-CFTAH] models). The virtual sub-study consisted of analysis of preoperative thoracic radiographs and computed tomography (n = 3; 4.2, 5.3, and 10.2 kg) imaging data.ResultsP-CFTAH pump fit in 21 out of 40 patients (fit group, 52.5%) but did not fit in 19 patients (non-fit group, 47.5%). I-CFTAH pump fit all of the 33 patients evaluated. There were critical differences due to dimensional variation (p < 0.0001) for the P-CFTAH, such as body weight (BW), height (Ht), and body surface area (BSA). The cutoff values were: BW: 5.71 kg, Ht: 59.0 cm, BSA: 0.31 m2. These cutoff values were additionally confirmed to be optimal by CT imaging.ConclusionsThis study demonstrated the range of proper fit for the P-CFTAH and I-CFTAH in congenital heart disease patients. These data suggest the feasibility of both devices for fit in the small-patient population

〔研究ノート〕 マウスのエタノール代謝における柿茶濃縮物の影響

Hangovers resulting from excessive alcohol consumption are largely caused by the acetaldehyde produced during alcohol metabolism. Persimmon fruit and persimmon leaf extracts are generally regarded as useful for "sobering up" and for reducing blood pressure. It is believed that these effects are due to the activity of polyphenols and tannin. Tannin, a component that gives persimmons and persimmon tea their astringency, is a water-soluble plant polyphenol that forms water-insoluble complexes with proteins, alkaloids, heavy metals, and other compounds. To identify the novel physiological functions of persimmon leaf extracts, concentrated extracts of persimmon leaves were prepared by extracting leaves with boiling water. The efficacy of the extracts in preventing alcohol-induced hangovers was determined by monitoring acetaldehyde concentrations in the blood of mice that first had been administered persimmon leaf extract, and then were administered ethanol. The results of the study indicate that acetaldehyde production can be suppressed by administering persimmon tea prior to alcohol intake