Total artificial heart as a bridge to transplantation

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Transplantation Medicine

Background:

• Total artificial hearts (TAHs) have been used for 50 years to treat biventricular heart failure.
• Devices and implantation techniques have evolved to improve patient outcomes.
• TAHs serve as a critical bridge to heart transplantation.

Purpose of the Study:

• To review the historical development of TAH devices.
• To discuss current TAH technologies and their clinical application.
• To outline patient selection, implantation strategies, and future directions for TAH therapy.

Main Methods:

• Literature review of TAH evolution, current devices, and clinical outcomes.
• Analysis of patient selection criteria and surgical implantation techniques.
• Discussion of challenges and future advancements in TAH technology.

Main Results:

• The SynCardia TAH is the most studied device, FDA-approved as a bridge to transplant, with over 2000 implants globally.
• One-year survival for TAH patients is 42%; one-year post-transplant survival for those receiving a heart is 83%.
• The Aeson TAH is a newer device undergoing clinical trials in the US.

Conclusions:

• TAH technology and implantation techniques have progressed substantially.
• TAHs provide reliable and often the sole therapeutic option for severe biventricular failure.
• Continued innovation promises further improvements in TAH therapy for end-stage heart disease.