Artificial Heart

What is an artificial heart?

An artificial heart is a mechanical pump that replaces the ventricles in your heart when they aren’t working as they should. Ventricles are the lower chambers of your heart. You have a left and a right ventricle. When you receive a total artificial heart, the device replaces both ventricles.

The artificial heart does the job the ventricles can no longer do: pump blood where it needs to go. An artificial heart connects to your heart’s two upper chambers (atria) and your major arteries.

How does an artificial heart work?​

A portable air compressor (driver) outside your body powers the artificial heart and keeps it pumping at a steady rhythm. The driver pushes air through two drivelines (tubes). These tubes connect the artificial heart to the driver. The tubes stick out of your body through the skin in your stomach (abdomen). You can recharge the driver battery at home or in your car.

It may seem strange to have a mechanical device in your chest. But artificial hearts have given people like you the help they need while waiting for a heart transplant.

Why do people get an artificial heart?

You may need a total artificial heart if you have:

• A congenital (present at birth) heart issue
• Heart failure
• A massive heart attack
• Cardiogenic shock
• A failed left ventricular assist device (LVAD)
• A dangerous arrhythmia (abnormal heart rhythm)
• Cardiomyopathy (heart muscle disease)

These heart conditions can affect how well your heart functions. The damage or disease may eventually leave your heart unable to pump blood efficiently.

Not having enough blood circulating through your body can lead to a variety of symptoms and conditions, including:

• Fatigue
• Low blood pressure (hypotension)
• Fluid buildup that shows up as swelling (edema) in your belly or ankles
• Shortness of breath (dyspnea)
• Difficulty lying down flat

Most people who receive a total artificial heart are waiting for a heart transplant. An artificial heart is a temporary solution until you get a transplant. Your provider may refer to the artificial heart as a “bridge to transplant.”

Researchers developed artificial hearts for people who aren’t good candidates for an LVAD. For example, a surgeon would need to fix complex issues in someone born with a heart issue before they could place an LVAD. Other people may have heart valves that don’t work well. An LVAD can’t help with that, but an artificial heart comes with valves.

Replacing your damaged ventricles with a total artificial heart can help you regain strength. It can help you stay healthy enough for heart transplant surgery as soon as a donor heart is available.

How should I prepare for this procedure?

You’ll need to be in the hospital for at least a week as you prepare for an artificial heart transplant. Your healthcare team will teach you and your family about the artificial heart. You’ll learn what to expect, how it’ll affect your health and lifestyle, and what to do if you have issues with your device.

During your time in the hospital, your providers will also ensure that you’re healthy enough for artificial heart surgery. You may need a variety of tests to assess how well your lungs and other organs work. Blood tests provide information like your blood type (in case you need a blood transfusion). Imaging can show if you have enough room in your chest for an artificial heart.

Tests before surgery may include:

• Blood tests
• CT scan
• Chest X-ray
• Electrocardiogram (ECG or EKG)
• Echocardiogram
• Pulmonary function testing
• Heart catheterization
• Metabolic exercise stress test

What happens during this procedure?

A team of heart surgeons and other specialists performs the operation. You’ll be under general anesthesia (fully asleep with a breathing tube) throughout the procedure. Providers monitor your breathing, heart rate, blood pressure and other vital signs.

A ventilator helps you breathe while you’re under anesthesia. A heart-lung bypass machine keeps blood circulating through your body during the operation. You’ll stay connected to the machine until the surgeons place the artificial heart in your chest and it starts pumping.

A provider will:

• Cut into your chest to open your breastbone (sternum), which is called a sternotomy
• Stop your heart with medicine so it stays still during the operation
• Remove your heart’s two ventricles
• Attach the artificial heart to your upper chambers (atria) and connect it to your aorta and pulmonary artery (these major blood vessels carry the blood your heart pumps)
• Turn off the heart-lung bypass machine
• Turn on the artificial heart

How long does this procedure take?

An artificial heart replacement may take up to nine hours. The procedure is complex.

What happens after this procedure?

Immediately after surgery, you’ll go to the intensive care unit (ICU) for close monitoring. You may need a ventilator to help you breathe for a few days while in the ICU. You’ll likely get nutrition through a feeding tube or intravenous (IV) line. You’ll also receive medicine for pain.

As you begin to recover, you’ll be able to start breathing, eating and drinking on your own. Gradually, you’ll be able to get up and move around the hospital.

Your healthcare team will monitor you closely for signs of infection or other complications during your recovery. If everything is working well the day after surgery, a surgeon will close your chest. They don’t close it right after surgery in case they need to go back into your chest.

What are the benefits of an artificial heart?

After receiving an artificial heart, you’ll regain strength and feel better than you did before surgery. This may take time, but the total artificial heart can help you get strong and healthy enough to receive a heart transplant.

Without a total artificial heart, many people die while waiting for donor hearts to become available.

What are the risks or complications of an artificial heart?

People who need an artificial heart are already dealing with serious health conditions. Getting a total artificial heart improves your health in many ways. But the surgery and living with the device increase your risk of other complications, including:

• High blood pressure
• Bleeding
• Anemia
• Blood clots
• Stroke
• Infection
• Kidney failure
• Liver failure

Some people may not survive this major surgery.

What is the recovery time?

You’ll likely spend at least a month recovering in the hospital after an artificial heart transplant. The first several days after surgery, you’ll stay in the ICU so that your healthcare providers can closely monitor your condition.

When you leave the hospital, you can slowly increase your activity. The device that powers and controls your artificial heart is portable. You can carry it in a backpack or shoulder bag so that you can move around freely.

How can I take care of myself with an artificial heart?

Caring for yourself with an artificial heart includes:

• Going to regular checkup visits to make sure the artificial heart is working well
• Taking medications to help prevent blood clots and infection while following your healthcare provider’s directions carefully
• Eating foods that are good for your heart
• Getting a good night’s sleep
• Taking part in cardiac rehab if your provider recommends it

How long can you live with an artificial heart?

You can live with an artificial heart for several months while waiting for a transplant. With today’s artificial hearts, 60% to 80% of those who receive one survive long enough to get their transplants.

Once you recover from surgery, you’ll likely feel stronger and healthier than you did before receiving the total artificial heart. That’s because the device is pumping blood through your body. Receiving an artificial heart can increase your chance of being able to get a heart transplant.

When should I see my healthcare provider?

You should call your healthcare provider after your surgery if you experience:

• Fever
• Signs of infection
• Stroke symptoms
• Sudden shortness of breath, chest pain or other signs of a blood clot in your lungs (pulmonary embolism)