SynCardia TAH-t Instructions for Use
SynCardia Systems, Inc.
Page 17
outflow connector, taking care not to twist the connector or aorta.
While this is being done, the artificial left ventricle should be filled
with saline through the aortic valve as well as the outflow connector.
Once the connection is made, the patient is
placed in a steep
Trendelenburg position and large vent sites are placed in the highest
point of the aortic outflow connector and the aorta for removal of air.
•
The artificial right ventricle is then connected. The atrial connection is
made first, again taking care with the orientation of the artificial right
ventricle so that the direction of flow from the outlet valve is
appropriate for the anatomy of
the
patient. After the atrial connection
is made, the pulmonary outflow connection is made, again, taking care
not to twist. Before connecting the pulmonary outflow connector graft,
the chokers on the superior and inferior vena cava should be removed.
This allows a flow of blood into the right atrium and the right artificial
ventricle, and flushes air out as the connection to the pulmonary artery
is made (Figure 8).
Figure 8: SynCardia TAH-t Final Position
•
With the patient in extremely steep Trendelenburg position and lungs
being slowly ventilated, begin pumping at a very slow rate (40 BPM,
40%SYS, 180mmHg-LDP, 60mmHg-RDP, 0mmHg-VAC). Agitation
of the artificial ventricles, as well as atria, is done at this time. If
available, monitor for air bubbles in the atria and aorta with
transesophageal echo to help decide when the device has been
completely de-aired. As air is slowly removed from the device,
increase pumping rate and pressure. Generally, this process takes about
10 minutes and should be done with patience and attention to remove
