Care of the Patient with a SynCardia Total Artificial Heart

As the number of patients with end-stage heart failure in need of a heart transplant continues to rise, the number of donors remains inadequate to meet that need. Therefore, the decades-long search for a replacement heart continues. To this end, several total artificial hearts (TAHs) have been designed and/or abandoned. Several TAHs have leaped human trials and even approval. However, only a handful of these devices are still being produced or utilized successfully. The only TAHs available today are the 70-cc and the 50-cc Syncardia TAH-t, which received US Food and Drug Administration (FDA) approval in 2004 and 2020, respectively. Both sizes of the Syncardia TAH-t are also approved for implantation in Canada and Europe. Indicated only as a bridge to transplantation (BTT), the SynCardia TAH-t is also being studied as destination therapy (DT). Proper patient selection with meticulous post-operative care by a skilled team at a high-volume center leads to optimal outcomes in patients with end-stage heart failure who require a TAH as BTT. Artificial hearts in development are based primarily on what has been learned using currently available technology while incorporating novel features. The hope is that 1 day, artificial heart replacement will be not as a BTT but, rather, as a permanent substitute for the diseased heart.