The ongoing quest for the first total artificial heart as destination therapy

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Device Development

Background:

• End-stage heart disease leads to mortality due to donor heart scarcity.
• Total artificial hearts (TAHs) have served as a bridge to transplantation for over 1,700 patients.
• Current TAHs are not suitable for destination therapy due to drawbacks like high complication rates and poor durability.

Purpose of the Study:

• To review historical milestones and lessons learned in total artificial heart (TAH) research.
• To discuss the next generation of TAHs and emerging technologies.
• To highlight challenges and future perspectives for TAH development.

Main Methods:

• Historical review of total artificial heart (TAH) research and development.
• Analysis of working mechanisms of existing and next-generation TAH devices.
• Identification of emerging technologies impacting TAH advancement.

Main Results:

• Over six decades of TAH research have yielded temporary solutions but not a destination therapy device.
• Innovations in battery technology, wireless energy, biocompatible materials, and soft robotics offer potential solutions.
• Current TAH drawbacks include high complication rates, bulkiness, poor durability, and low quality of life.

Conclusions:

• Emerging technologies present a promising opportunity to overcome current TAH limitations.
• Future TAH development requires addressing biocompatibility, durability, and patient quality of life.
• Significant challenges remain, but advancements are paving the way for TAHs as a viable destination therapy.