Hello and welcome back to ACRAC. I'm Jed Wolplot and I am thrilled because I have back with me today the one and only Dr. Micah Sando from the Ohio State University and listeners will be impressed that he has ventured out solo without his fellows today.

So it's just me and Mike and we have a really exciting topic we're going to talk about the total artificial heart which Mike has become someone of an expert on and is going to share a lot of really great information not only for folks who may be dealing with these in terms of implantation but for anyone out there who may have a patient in the future who has one of these and is take coming in for non cardiac surgery so Mike thanks so much for coming back on the show. Thank you so much. It's always a pleasure to be on ACRAC. All right. Well, let's jump right in and I should say of course folks who are coming for

listeners will know that you are a professor of cardiac anesthesiology at Ohio State University and so obviously very very much in the know about these topics. So let's start with the very basics when we say total artificial heart I mean you know in a way this is kind of like the dream right for an organ that needs to be transplanted I mean if we could just make a kidney or make a liver we would be able to you know do away with the waiting list right so a heart is another thing we transplant into people who need a transplant and it sounds like when we say

total artificial heart we we are making one is that right is this a heart we can transplant into someone that is created from scratch.

All right. So I would like to say first of all you know at Ohio State you know we we have a pretty robust total mechanical support and transplant program it's led by Dr. Nehush Mokadam and Dr. Brian Whitson. So I gave a lot of credit to you know surgeons because you know based on their really robust program we on the anesthesia you know

aspect of things can learn a lot about these technology such as the total artificial heart so so essentially what is the total artificial heart it's actually a mechanical

circulatory support device that replaces the ventricle so that's by the fact that it's named a total artificial heart it's a total

artificial heart because it takes over the physiologic functions of the heart but the device though it has two ventricles that are

essentially anastomose to the left atria and the right atria and then the you know the right pump is connected to the pulmonary artery and then the left pump is you know

connected systemically you know to the aorta so it's a pretty phenomenal device that essentially provides a

circulatory support it's the it's a durable pump that's available for patients with bi ventricle heart failure so it's

different from you know love ventricle devices in triodic balloon pumps in a sense that this is the only device that

provides circulatory support to both ventricles and a little historical perspective on the total artificial so the device was

designed in the 19th late 50s to 1960s by a phenomenal surgeon from Argentina Dr. Domingo Leota and he was working with the great Dr.

De Bay key over in Houston and then they they they essentially created a total artificial heart but the first implant was by another famous

cardiac surgeon Dr. Denton Cooley it was in 1969 and it was in a patient who also a lot of you know people in cardiac surgery would know about Mr. Hasco

carp who had a refractory bi ventricle heart failure you know they he underwent surgery they did resection of some of the ventricles but after they

put the heart back together you know they didn't have enough you know my cardium to essentially provide enough you know strobe volume to support the patient

so it was either the patient sort of say you know passed away on the table or they implant a device that could support him as a bridge to heart

transplantation so they didn't the device in 1969 the patient did well for three days and then he ended up you know

undergoing heart transplantation and he did very well so it was a great it was a great bridge to heart transplantation

and since then the device has been refined over the years and it's still what we use today.

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