Precise monitoring of transpulmonic resistance in bridge-to-transplant patients supported by the Aeson total artificial heart.

Abstract

The Aeson total artificial heart (TAH) features embedded pressure sensors for flow autoregulation, which can also be used to estimate pressure gradients. In this bridge-to-transplant study, right and left ventricular pressure data and pump output from the TAH were analyzed to estimate transpulmonic resistance (eTPR) every 30 days. Three patients (aged 60, 35, and 54) with preimplant pulmonary vascular resistance of 7.0, 3.2, and 7.1 Wood Units, respectively, were supported by the TAH at pump outputs of 4.5 to 6.5 liter/min. All showed significant eTPR reductions (1.4-1.5 Wood Units) and received donor hearts after 243, 155, and 109 days of support. Two patients underwent successful transplants without complications; one died post transplant from pneumonia and multiorgan failure. The Aeson TAH's eTPR monitoring system offers a promising, noninvasive approach to managing pulmonary hypertension and assessing transplant eligibility in real time.