Are Totally Implantable Artificial Hearts Ready For Heart Failure Patients?

— -- Question: Are totally implantable artificial hearts ready for heart failure patients?

Answer: So, there is no such thing as a totally implantable artificial heart. All of the current devices that we can plant to help the heart do its work have an external power source. However, there is a total artificial heart that has been approved by the FDA as what's called a bridge to transplant. So, patients who are on the transplant list but are not expected to survive until a donor heart is identified, which can sometimes take months to years, can be eligible for the total artificial heart.

The total artificial heart substitutes not only for the left ventricle, the main pumping chamber of the heart, but for the right side of the heart, which pumps blood into the lungs. In some patients, the right side of the heart has become very weak as well, and cannot effectively pump the blood into the lungs to get to the left side of the heart, the main pumping chamber of the heart. If the left side of the heart is predominately the weak side, a Left Ventricular Assist Device is the optimal therapy. But if the right side has also become weak, a total artificial heart implant may be the only life-saving therapy available to such a patient.

Again, it's not totally implantable because the power supply remains external to the body. And until very recently, these devices had no portable drive line unit so that patients who had total artificial hearts had to remain in the hospital until their transplant -- although this is changing with current technology and the ability to discharge these patients to home is being tested currently. The Left Ventricular Assist Devices that just substitute for the left-sided pumping chambers do allow patients to leave the hospital and live at home and restore quality of life to a much greater degree than the total artificial heart at the current time. But these technologies are evolving so quickly that within five years, there will likely be total artificial heart that allows you to go home.