SynCardia TAH-t Instructions for Use
SynCardia Systems, Inc.
Page 12
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Incision can be done with a knife and extended with a knife or scissors.
It is extended anteriorly across the right ventricular outflow tract and
just proximal to the pulmonary valve. Posteriorly, it is extended to the
interventricular septum and across the septum, staying on the left side
of the arterioventricular (AV) groove and preserving the entirety of the
mitral annulus. The anterior and posterior lines of incision are dissected
apart from each other out to the level of the pulmonary bifurcation.
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Trim the excess muscle on the right and left sides down to near the AV
valves. All chordae are trimmed away, and a 2 mm edge of valve tissue
along with the annulus is left intact. The atrial cuff generally extends 1
cm beyond the AV valves and consists of residual ventricular muscle
and fat in the AV groove. The portion of the cuff in the left ventricular
outflow tract consists of the residual anterior leaflet of the mitral valve
and some aortic tissue. Most of the aortic tissue is trimmed away;
however, some is left intact because it is felt to present strong tissue for
the sewing of the inflow connector. The great vessels are then
separated from the remaining ventricular myocardium above the
valvular level. The great vessels are separated from each other (Figure
3).
Figure 3: Ventricles Removed
Over-sew the coronary sinus entrance into the right atrium. This
prevents backflow of blood through the coronary sinus and out to the
cut vessels on the AV groove.
