Total artificial heart

Overview

A total artificial heart (TAH) serves as a mechanical substitute for a malfunctioning or diseased heart, with both left and right ventricles replaced by the device. Implanted by a heart surgeon, the TAH is powered by a portable external machine that ensures a consistent pumping rhythm. A driveline, extending from the TAH to the external device, exits the body through the abdominal skin. This innovative solution becomes essential when the natural ventricles are unable to perform their cardiac function effectively.

Reasons for undergoing the procedure.

If you have a congenital heart defect or heart failure, your heart may not be working well, making it difficult to pump blood efficiently. This can lead to symptoms like fatigue, low blood pressure, fluid build-up, shortness of breath, and difficulty lying flat. In such cases, a total artificial heart might be needed as a temporary solution while waiting for a heart transplant, often referred to as a “bridge to transplant.” This artificial heart replaces damaged ventricles, helping you regain strength and maintain enough health for the eventual transplant surgery when a suitable donor heart becomes available.

Risks

People who need a total artificial heart are already dealing with serious health problems. Getting this artificial heart can make you healthier, but the surgery and living with the device can also bring other issues like bleeding, blood clots, strokes, and infections.

Before the procedure

Prepare for a week-long hospital stay as you get ready for total artificial heart surgery. Your healthcare team will educate both you and your family about the artificial heart, offering insights into its impact on your health and lifestyle. Throughout your hospitalization, medical professionals will assess your suitability for the surgery through various tests, ensuring your overall health is optimal for the procedure. These pre-surgery tests may encompass a range of assessments to thoroughly evaluate your condition and prepare you for the upcoming artificial heart implantation. Tests before surgery may include:

• Blood tests.
• Computed tomography (CT) scan.
• Chest X-ray.
• Electrocardiogram (ECG or EKG).
• Echocardiogram.
• Pulmonary function testing.
• Heart catheterization.
• Cardiopulmonary stress testing (metabolic stress test).

During the procedure

Total artificial heart surgery is a intricate procedure that can span up to nine hours, conducted by a team of specialized heart surgeons and other medical professionals. Throughout the surgery, you will be under general anesthesia, closely monitored for vital signs such as breathing, heart rate, and blood pressure. A ventilator aids in breathing while the heart-lung bypass machine ensures continuous blood circulation. The connection to the machine persists until the artificial heart is implanted in your chest and begins its pumping function.

After the procedure

After surgery, you’ll move to the intensive care unit (ICU) for close monitoring. Initially, you may need respiratory assistance from a ventilator and receive nutritional support through a feeding tube or intravenous (IV) line. As you recover, you’ll gradually regain the ability to breathe, eat, and drink independently. The step-by-step improvement in mobility will allow you to move around the hospital. Your healthcare team will diligently monitor you for signs of infection or potential complications throughout the recovery period.

Outcome

Recovery after receiving a total artificial heart typically involves a hospital stay of at least a month, with the initial days spent in the intensive care unit for close monitoring. As you progress, you can gradually increase your activity level, aided by the portability of the device, which can be carried in a backpack or shoulder bag.

During your recovery, it is essential to adhere to your healthcare provider’s instructions, especially regarding medications to prevent blood clots and infections. The total artificial heart serves as a temporary solution for individuals awaiting a heart transplant, allowing them to lead a relatively normal life for several months or even years while on the transplant waiting list.

Following surgery, you can experience an improvement in strength and overall health as the artificial heart assists in pumping blood throughout your body. This increased well-being also enhances your eligibility for a heart transplant. Embracing this technology not only supports your immediate health but also boosts your prospects of successfully receiving a new heart in the future.