Understanding Total Artificial Heart

A total artificial heart is a pump implanted in your chest to take over the job of your failing heart. It's a temporary device until you can receive a heart transplant with a donor heart. This may be called a bridge to a transplant.

The pump takes over the work of the heart's lower chambers (ventricles). It also replaces the heart valves that control blood flow in the heart. It's connected to a machine outside the body called a driver. This portable device powers the artificial heart. The driver is at your bedside in the hospital. Once discharged, you carry the driver with you in a backpack or a shoulder bag. It's connected to the heart with tubes tunneled under the skin.

A total artificial heart is used in advanced heart failure and other heart conditions when a donor heart is not yet available for transplant. It may be used when a ventricular assist device (VAD) is not a choice. Other reasons a total artificial heart may be used include:

• Ventricular arrhythmia that is not controlled
• Congenital heart defects in end stage
• Broken or burst (ruptured) ventricles
• Failing left ventricle after a valve replacement
• Blood clots in the blood vessels
• Heart transplant rejection

In general, here is what you can expect during the procedure:

• You will receive medicine to make you sleep during the surgery.
• You will have a breathing tube connected to a ventilator to help you breathe. You will also be hooked up to a heart-lung bypass machine that will keep blood oxygenated and circulating in your body.
• Your chest bone is cut open.
• The surgeon uses medicine to stop your heart so they can operate on it.
• The ventricles are removed and the artificial ventricles are attached to the upper chambers and major arteries.
• After the total artificial heart is attached, the heart-lung bypass machine is turned-off and starts the total artificial heart.
• The chest incision may be left open for one day after surgery.
• If the total artificial heart is working correctly and there is no abnormal bleeding, the chest is closed

Expect to spend a few weeks or longer in the hospital as you recover. During this time, your doctors will help you learn to care for your device. You will need to take anti-clotting medicine to prevent blood clots. And you will take other medicines to help your recovery and prevent infection. Cardiac rehab may be advised to help you safely increase your activity level while being supervised by healthcare professionals. You'll also learn about heart-healthy lifestyle changes.

All procedures have some risk. Possible risks and complications of this procedure include:

• Blood clots
• Stroke
• Anemia
• High blood pressure
• Bleeding
• Infection
• Liver or kidney failure
• Device malfunction
• Death