An artificial heart is a manufactured device that helps improve the function of a damaged heart. Typically, doctors use these devices when someone is awaiting a transplant and their heart can no longer beat on its own.

The artificial heart provides mechanical circulatory support and is often a temporary measure. A total artificial heart is a device that replaces all four chambers of the heart and its valves.

Another device, called a ventricular assist device, also provides mechanical support. This device is a heart pump that helps the ventricles of the heart pump blood around the body.

Some reasons that a doctor may recommend an artificial heart device are below:

  • Bridge to transplant: They can help keep people alive while they wait for a donor heart transplant.
  • Bridge to recovery: They can give the heart the chance to heal and recover some of its typical functions.
  • Destination therapy: They can support blood circulation for people who are too ill to receive a donor heart.

Keep reading to learn more about artificial hearts and other device implants for treating heart conditions.

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A TAH is a temporary device that surgeons can implant to replace a nonviable heart that may have a disease.

It works by mechanically pumping blood using artificial ventricles and valves. It consists of material that aims to prevent rejection. An external driver controls its pump action.

Unlike other devices that help treat heart conditions, a TAH replaces both sides of the heart, including the left and right ventricles and four heart valves.

The only TAH with approval from the Food and Drug Administration (FDA) is the SynCardia Total Artificial Heart. The FDA approves its use as a temporary measure until a person can receive a heart transplant.

An artificial heart can cost anywhere from $190,000 to $220,000.

What can it treat?

According to the National Heart, Lung, and Blood Institute, a TAH treats heart failure in people whose ventricles can no longer effectively pump blood. A doctor may also recommend it for those who are unsuitable candidates for heart transplant surgery.

The TAH may also be an option for individuals with congenital heart disease.

According to a 2021 review, about 2,000 people have received the TAH.

Although Julien Jean Cesar LeGallois, a French physician, proposed the theory of mechanical circulatory support in 1812, it did not become a reality until many decades later.

Some key moments in the development of the modern-day artificial heart are:

  • 1947: Dr. Willem Johan Kolff, a prolific artificial organ inventor, begins work on the artificial heart.
  • 1963: Paul Winchell and Dr. Henry Heimlich invent an artificial heart device and hold the first patent for it. They eventually gave the patent to Dr. Kolff.
  • 1969: An artificial heart — a design of Dr. Domingo Liotta — is implanted in a human for 64 hours. However, the patient dies 32 hours after receiving a donor heart.
  • 1971: Robert Jarvik, Don Olsen, and Dr. William DeVries join Dr. Kolff’s team in 1971. This team tests several prototypes of the TAH in calves.
  • 1982: Doctors successfully implant the Jarvik 7 artificial heart into Barney Clark, who survives for 112 days.
  • 1985: Dr. Jack Copeland successfully uses Jarvik 7 as a bridge to a human heart transplant.
  • 1991: Jarvik 7 becomes the CardioWest Total Artificial Heart. Clinical trials continue.
  • 2004: The CardioWest Total Artificial Heart receives approval from the Food and Drug Administration (FDA) and is now known as the Syncardia temporary CardioWest Total Artificial Heart.

VADs are artificial heart pumps that doctors may recommend if a person is awaiting heart transplantation. It may serve as a short- or long-term solution for people experiencing heart failure.

These devices help the heart’s ventricles pump blood around the body and reduce the workload of a damaged heart. A device that helps the left ventricle is called a left ventricular assist device (LVAD). Conversely, a device that helps the right ventricle is called a right ventricular device.

These devices consist of three parts:

  • a pump that doctors insert inside or outside the body
  • a system controller, which controls how the pump works
  • a power source, for example, a battery

With the LVAD — the pump draws blood from the left ventricle and moves it into the aorta. The aorta, a major artery, is responsible for transporting blood around the body.

The HeartMate II Left Ventricular Assist System is an example of an LVAD.

The procedure for TAH and VAD insertion varies. Recovery from surgery may take at least a month. During this time, doctors will closely monitor a person’s health.

TAH

This is the typical procedure for a TAH surgery:

  1. Healthcare professionals will put a person to sleep using anesthesia.
  2. Because surgeons need to stop the heart to perform this procedure, they will insert a breathing tube and connect it to a ventilator.
  3. During the stoppage of the heart, a bypass machine ensures oxygenated blood continues to flow through the body.
  4. Surgeons then open the ribcage to place the TAH. However, they will not remove the heart altogether. Instead, they will remove the ventricles and attach the device to the aorta and upper heart chambers.
  5. Once the device is in place, the medical team will turn off the bypass machine to check that the device works properly and can efficiently pump blood.
  6. The surgery finishes when the medical team closes up the chest.

VAD

Below describes a typical VAD procedure:

  1. The surgeon makes an incision on the breast bone and spreads the ribcage to access the heart. Some patients may also require a bypass machine.
  2. The design and the size of the pump will determine where surgeons insert the pump. For the LVAD, a surgeon may implant the device below the heart, in the upper abdomen.
  3. Once the device is in place, the surgeon connects a tube to the tip of the left ventricle.
  4. They also place another tube from the pump and connect it to the aorta.
  5. The surgeon attaches one final tube, through the wall of the upper abdomen, to the pump’s power source and controller.
  6. Finally, the surgeons check that the device is working properly before taking them off the bypass machine and stitching the chest.

The FDA has approved the TAH as a temporary measure for people awaiting a heart transplant. The device can support people for about 4 years.

While some people may live longer, it should not be a permanent solution to heart transplantation.

Mechanical circulatory support devices come with some risks. People can experience:

Additionally, a TAH may not work for people with small chest cavities, blood clotting disorders, chronic organ failure involving other organs, and body wasting.

The surgery to insert the device may also carry some risks, such as bleeding and kidney failure, among others.

There are some other artificial devices that doctors can insert into the heart. They include artificial heart valves and pacemakers.

Artificial heart valves

Artificial heart valves are devices to replace damaged valves in the heart. There are four valves in the heart, which ensure that blood moves in the correct direction during each contraction of the organ. They also prevent the backflow of blood.

Doctors may use mechanical or tissue valves when they replace damaged ones in the heart. Tissue valves may come from pigs or cows, and each type has its own benefits and drawbacks.

Learn more about mechanical heart valves here.

Mechanical circulatory support devices, such as the TAH and VAD, can help improve the heart’s function. The implanted TAH device can treat heart failure affecting both sides of the heart. In contrast, VADs treat heart failure by replacing damaged ventricles of the heart.

Both devices can help someone live longer while they await a heart transplant.

There are some risks relating to the implantation surgery and artificial heart device themselves. These can include bleeding and infection, and in some cases, the device might fail.