FLEXIBLE IMPLANTABLE PEDIATRIC TOTAL ARTIFICIAL HEARTS: THE FUTURE IS HERE

Abstract

In pediatric patients with congenital heart diseases need for ventricular assist devices adds on to risk score, especially in single ventricle situations. If technology provides with devices that could t into the available pericardial space without venous compression, total articial hearts would be the acceptable rst option in pediatric patients with indications for the same, the repertoire of which is continuously expanding with availability of smaller devices and emerging horizon of drive less articial hearts. Borderline situations can be very correctly evaluated using virtual t technologies. Of around 1000 TAH implants worldwide, less than 5% are pediatric, the volume of which would increase exponentially if exible implantable pumps with adequate hemodynamics emerge in the eld. Though initial applications centre on bridge to transplant, emerging technologies would make it feasible as destination therapy. Syncardia 50cc and evolving versions of Saispandan, based on hybrid bearing less switched reluctance motors which are ultra miniaturized are exciting prospects. But the future belongs to exible articial organs which would include implantable micro pumps that are centrifugally levitated with specialized impeller coating and CET charging methods. Total articial hearts would be the gold standard management in horizon for pediatric biventricular failure. Use of soft materials and exible electronics with tissue compatible materials are emerging fast to revolutionize the domain of cardiac surgical practice. Future is for exible articial organs – pediatric total articial hearts, microuidac lungs to begin with.