271 Treatment of thrombophlebitic necrotic lesions in a patient with syncardia—a case report

Aims The 58 years old male patient with an important dilated cardiomyopathy, carrier of ICD, numerous malignant arrhythmias (VT) and without the possibility of a timely heart transplant, underwent emergency surgery by implanting a total artificial heart syncardia. Necrotic tissue was already present on the forearm and in the antecubital region before the surgery; it was caused by extravasation and thrombophlebitis due to continuous intravenous therapies and the lesions were deep down to tendons and bones after a surgical toilet. Years of unstable haemodynamics caused by dilated cardiomyopathy and low cardiac output led to poor peripheral vascularization giving priority to noble structures. Restoration of the tissue using advanced dressings without the use of skin grafts avoiding bacterial infections in a fragile patient. Methods and results A Pubmed search for advanced dressings was performed and a Webinar on the Wound Hygiene technique was attended. In the first instance, a polyurethane foam dressing was used and the wound on the forearm showed major improvements, subsequently with the synergistic help of the ‘Wound Hygiene’ technique and dressings based on connectivine, the tissue healed. The wound located in the antecubital region had continuous biofilm formation and a VacTherapy was planned for this. After 7 days, the conditions worsened and for this reason it was decided to use the Aqua Cell Ag +. This dressing with the silver helps in the formation of granulation tissue and it also prevents infections ‘trapping’ bacteria inside it. Conclusions The use of dressings with the Wound Hygiene technique led to the formation of new tissue without the need to perform a skin graft in a patient with a total artificial heart and without bacterial infections.

Analysis and regulation of the cardiovascular system of univentricular heart with different configurations of the total cavopulmonary connection

The cardiovascular system (CVS) is a complex mechanism capable of reacting and regulating various changes in external and internal parameters. A particular problem is the study of CVS with univentricular heart. We studied the hemodynamic response of the CVS to the use of various configurations of bypassing the right side of the heart. During our research, we selected three different configurations of the total cavopulmonary connection. All configurations were made from Clear Flex 50 and tested in an experimental workbench. According to the research results, the TCPC-3 configuration is the most optimal. It has symmetrical output values of flows and pressures and there is no significant increase in inlet pressure. The results of this study can be used to optimize the control of the parameters of the ventricular assist device and the total artificial heart.

DESIGN AND DEVELOPMENT OF MINIATURE SLOTTED IMPELLER FOR SAI SPANDAN TOTAL ARTIFICIAL HEART FOR DESTINATION THERAPY

In recent years, the use of rotary blood pumps (RBPs) as continuous ow VADs has surged ahead, and virtually eliminated the use of pulsatile-ow or volume-displacement pumps for implantable, chronic mechanical circulatory support (MCS). Circuit Design modications like that in Saispandan has imparted pulsatility into RBP.Impeller designs are a signicant factor when designing centrifugal pumps as mechanical circulatory assist devices as smaller diameter impellers with higher rotational speeds to achieve target outputs would cause more blood component trauma compared to larger diameter impellers.Hydraulic performance and hemolysis tests in the same pump housing with different prototypes is needed. Ventricular assist parameters for efcient circulatory support would include an output of 5 L/min against 100 mmHg at speeds of 2500-3500 rpm. Vein height does not contribute signicantly to evaluation metric in most studies.

Unconventional Use of Total Artificial Heart in a Patient With Severe, Destructive Prosthetic Valve Endocarditis

Here, we report the case of a patient who presented to our institution with severe, destructive, and un-reconstructable prosthetic valve endocarditis which required the planned implantation of a total artificial heart (TAH) to function as a bridge to cardiac transplantation.