The development of a control method for a total artificial heart using mixed venous oxygen saturation

For physiological control of a total artificial heart (TAH), applying mixed venous oxygen saturation (Svo(2)) as a parameter for TAH control is a promising approach regarding sensitivity to the recipient's oxygen demand and the practical possibility of continuous monitoring using near infrared rays through transparent blood pump housings. To develop a control method for the TAH using Svo(2), the relationship between Svo(2) and cardiac output (CO) was investigated in a normal calf, and a control algorithm was developed based on this correlation. Then the feasibility of this method (Svo(2) mode) was evaluated in a calf implanted with a pneumatic TAH and compared with the fixed drive control mode (fixed mode) in which the drive parameters were unchanged. The calf performed a graded exercise test in both modes. The CO was effectively increased from 7.3 to 13.0 L/min in the Svo(2) mode, and the capacity for exercise was augmented compared to the fixed mode. We conclude that this Svo(2) mode is feasible and may be effectively applied in TAH control.