Total Artificial Heart

What Is Total Artificial Heart?

Total Artificial Heart

A total artificial heart (TAH) is a pump that is placed in the chest to replace damaged heart ventricles and valves. (Ventricles pump blood to the lungs and other parts of the body.) Once the pump has been placed in the chest, a machine called a driver controls the pump outside the body. The pump and driver help blood flow to and from the heart, replacing the function of a healthy heart. A total artificial heart can help improve your quality of life and allow you to live longer.

A doctor may recommend a TAH as a long-term solution if you have heart failure caused by ventricles that no longer pump blood well enough. In certain patients who are not able to be considered for a heart transplant, TAH surgery also may be a longer-term treatment option.

How Does It Work?

The total artificial heart (TAH) replaces the lower chambers of the heart, called ventricles. Tubes called pneumatic drive lines run through holes in your stomach area to connect the TAH to a machine, called a driver, that sits outside your body. The TAH then pumps blood through the heart’s major artery to the lungs and the rest of the body.

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The TAH has four mechanical valves that work like the heart’s own valves to manage blood flow. These valves connect the TAH to your heart’s upper chambers, called the atrium, and to the major arteries, the pulmonary artery, and the aorta. Once the TAH is connected, it acts like a healthy heart, allowing blood to flow normally through the body. The TAH is powered and controlled by a machine – the driver – that’s placed next to the bed for patients in the hospital. After they leave the hospital, people with a TAH use a portable driver that fits in a shoulder bag or backpack and weighs about 14 pounds. It can be recharged at home or in a car.

Who May Benefit from a Total Artificial Heart?

You may benefit from a total artificial heart (TAH) if you have advanced heart failure caused by ventricles that no longer pump blood sufficiently and other treatments have not worked. Your doctor may also recommend a TAH while you wait for a heart transplant.

The Federal Drug Administration (FDA) approved the TAH device as a bridge to a transplant. TAHs help keep people with this type of heart failure alive while they wait for a heart transplant. In addition, artificial hearts have been given to a few patients as part of clinical research. Researchers are working on TAH devices that can be used as alternative treatments for adults who are not eligible for a transplant.

Who may not be eligible to get a TAH?

Your doctor will likely not recommend a TAH if you:

  • Are too small, as the device may be too large to fit in the chests of children and some adults 
  • Can benefit from other treatments, including medicines
  • Have heart failure on only one side of your heart and could benefit from a ventricular assist device instead
  • Cannot take anticlotting medicines, which are required as long as the TAH is in place
Possible surgery-related complications

After getting a TAH, as the case after any surgery, possible complications such as blood clots, bleeding, or infection, can develop.

Blood clots

Blood may clot more easily because of its contact with the man-made parts of the TAH. Blood clots can block blood vessels that deliver oxygen to important organs in your body. They can cause severe complications such as a stroke; a pulmonary embolism, which is a type of venous thromboembolism; or death. For this reason, you need to take anticlotting medicine as long as you have a TAH.

Bleeding

The surgery to connect a TAH to your heart is very complex. Bleeding can occur in your chest during and after the surgery. Anticlotting medicine also raises your risk of bleeding because it thins your blood. 

Infection

After surgery, you will be at a higher risk for infection, so your doctor may give you medicine to lower this risk. Your healthcare team will watch you closely for fever or other signs of infection.

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 During the TAH surgery, as in any major surgery, there is a risk of dying. There is also a risk that your body may respond poorly to the medicine used to put you to sleep during the surgery.

Information courtesy: https://www.nhlbi.nih.gov/health/total-artificial-heart

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