{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T01:26:05Z","timestamp":1771809965832,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Maintaining balanced left and right cardiac outputs in a total artificial heart (TAH) is challenging due to the need for continuous adaptation to changing hemodynamic conditions. Proper balance in ventricular outputs of the left and right ventricles requires a preload\u2010sensitive response and mechanisms to address the higher volumetric efficiency of the right ventricle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This review provides a comprehensive overview of various methods used to balance left and right ventricular outputs in pulsatile total artificial hearts, categorized based on their actuation mechanism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reported strategies include incorporating compliant materials and\/or air cushions inside the ventricles, employing active control mechanisms to regulate ventricular filling state, and utilizing various shunts (such as hydraulic or intra\u2010atrial shunts). Furthermore, reducing right ventricular stroke volume compared to the left often serves to balance the ventricular outputs. Individually controlled actuation of both ventricles in a pulsatile TAH seems to be the simplest and most effective way to achieve proper preload sensitivity and left\u2013right output balance. Pneumatically actuated TAHs have the advantage to respond passively to preload changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Therefore, a pneumatic TAH that comprises two individually actuated ventricles appears to be a more desirable option\u2014both in terms of simplicity and efficacy\u2014to respond to changing hemodynamic conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14641","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T09:05:45Z","timestamp":1694595945000},"page":"1809-1817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Balancing the ventricular outputs of pulsatile total artificial hearts"],"prefix":"10.1111","volume":"47","author":[{"given":"Oskar J.","family":"G\u00fclcher","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery Amsterdam University Medical Centers, Location University of Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Biomechanical Engineering Delft University of Technology  Delft The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2343-5686","authenticated-orcid":false,"given":"Annemijn","family":"Vis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Amsterdam University Medical Centers, Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4948-5585","authenticated-orcid":false,"given":"Mathias","family":"Peirlinck","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering Delft University of Technology  Delft The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"Kluin","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Amsterdam University Medical Centers, Location University of Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Cardiothoracic Surgery, Thorax Center Erasmus MC  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Organ Donation Statistics2023. 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