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Updated: Apr 26, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Implantation of total artificial heart in congenital heart disease
Iki Adachi1, David S L Morales2
1Congenital Heart Surgery, Texas Children's Hospital; Michael E. DeBakey Department of Surgery, Baylor College of Medicine.
Insights
A total artificial heart (TAH) is a feasible option for patients with end-stage heart failure (HF) and complex congenital heart disease (CHD). Technical modifications enable TAH implantation, successfully bridging patients to heart transplantation.
Area of Science:
- Cardiology
- Congenital Heart Surgery
- Mechanical Circulatory Support
Background:
- End-stage heart failure (HF) often necessitates advanced interventions.
- Congenital heart disease (CHD) presents unique challenges for cardiac device implantation.
- Total artificial hearts (TAH) serve as a bridge to cardiac transplantation.
Observation:
- A 17-year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressive HF and multisystem organ failure.
- The patient's complex cardiac anatomy posed significant challenges for TAH implantation.
- An implantable cardioverter defibrillator (ICD) was previously implanted but did not prevent deterioration.
Findings:
- A TAH was successfully implanted in the patient with CCTGA after necessary technical modifications.
- The TAH provided mechanical circulatory support, allowing the patient to recover and await a donor heart.
- The patient was successfully bridged to heart transplantation 5 months post-TAH implantation.
Implications:
- TAH implantation is technically feasible in select patients with structurally abnormal hearts due to CHD.
- This case demonstrates the potential of TAH as a viable bridge to transplant in complex congenital cases.
- Customized surgical approaches may be required for TAH implantation in patients with complex congenital heart defects.
Abstract:
In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient's grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient's ventricles and great arteries required modifications to the TAH during implantation. With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification.
