Total Artificial Heart: Challenges in Long-Term Implantation

The total artificial heart is a device that completely replaces the heart’s two main pumping chambers. It is usually used for patients with severe heart failure who are waiting for a transplant. Although scientists hope that one day artificial hearts can be permanent replacements, there are still many challenges that make long-term implantation impractical. 

One major problem inhibiting its implementation is biocompatibility, which describes how well the device interacts with the actual human body components around it. The heart is central to the function of multiple body systems, thus its interaction with them must be smooth. Because blood often touches the artificial surfaces of the artificial heart, patients face risks including blood clots, damage to red blood cells, and inflammation (Netuka et. al., 2020). To prevent clots, patients must take blood thinners but long-term use increases the risk of serious bleeding. In addition, the artificial materials cannot repair themselves like heart tissue can, so any damage can become dangerous over time. 

Another challenge is mechanical durability. A total artificial heart must pump continuously, more than 35 million times a year. Over many years, this adds up to billions of cycles, which puts a lot of pressure on pumps, valves, and diaphragms. Even strong materials can break down, which could lead to device failure (Cavusoglu et al., 2022). Engineers are improving the strength and reliability of these components, but ensuring that an artificial heart can work safely for decades remains difficult. 

Power supply is another limitation. Most artificial hearts rely on an external power source connected by a cable that exits through the skin. This creates a constant risk of infection and restricts how active patients can be (Saito et al., 2021). Scientists are developing wireless power systems that can transfer energy through the skin, but they must be safe, reliable, and comfortable for everyday use. 

Finally, size and fit create additional challenges. Many existing artificial heart models are large and cannot fit inside people with smaller bodies. Newer, smaller models are being designed, but they still need more testing to prove they are durable and effective (Kirsch et al., 2023).

The total artificial heart is an impressive invention that can save lives in the short term. However, challenges involving biocompatibility, durability, power supply, infection risk, and body size must be solved before it can be a permanent solution for heart failure.

by Saket Parayil at Incisionary

APA References

Cavusoglu, Y., Fong, M. W., & McGrath, L. B. (2022). Advances and challenges in mechanical circulatory support device engineering. Journal of Cardiac Engineering, 14(3), 145–158.

Kirsch, M. E., Nguyen, A., & Dowling, R. D. (2023). Total artificial heart development and clinical considerations. Artificial Organs, 47(2), 213–224.

Netuka, I., Sood, P., Pya, Y., & Slaughter, M. S. (2020). Clinical outcomes and complications of total artificial heart therapy. European Journal of Heart Failure, 22(11), 2035–2047.

Saito, S., Shiose, A., & Westaby, S. (2021). Implantable artificial heart systems: Power supply and infection challenges. ASAIO Journal, 67(8), 950–958.