Anatomical study of the Cleveland Clinic continuous-flow total artificial heart in adult and pediatric configurations

The purpose of this study was to assess the smallest possible body sizes of patients in whom the Cleveland Clinic continuous-flow total artificial heart for adult (CFTAH) and pediatric configurations (P-CFTAH) can fit. One of the most critical dimensions is the vertebra-to-sternum distance at the junction of the right atrium to the inferior vena cava (V–S distance). Our previous CFTAH anatomical fitting study suggested that the CFTAH would fit patients of V–S distance ≥ 7.5 cm and the P-CFTAH of V–S distance ≥ 5.25 cm (70% of 7.5 cm). To confirm this, we assessed the relationship between body surface area (BSA) and V–S distance in 15 adult patients (BSA 1.86–2.62 m²) and 31 pediatric patients (BSA 0.17–1.80 m²) whose computed tomography scans were available. We found a highly significant correlation between BSA and V–S distance (p < 1.0 × 10⁻²⁵). It appears that the CFTAH will fit in most patients with BSA ≥ 1.0 m² (corresponding height of ≥ 130 cm and age of 9 years) and the P-CFTAH in patients with BSA ≥ 0.3 m² (corresponding height of ≥ 55 cm and age of 1 month). Further anatomical fitting studies are needed to evaluate the two pump models inside human chests to determine the smallest patient size/critical dimensions and device port configurations.