A total artificial heart provides mechanical circulation by replacing the heart's pumping ventricles and their valves. It is a major treatment decision involving the implant, an external support system and a specialist team. Families need to understand both the immediate goal and what continuing care would involve.
The National Heart, Lung, and Blood Institute explains total artificial hearts and their role in supporting selected people with severe heart failure, often while awaiting a transplant. The name can suggest a self-contained replacement; ask the team to show you every part of the proposed system, including equipment outside the body.
Distinguish replacement, assistance and rhythm treatment
| Term | Main role | Question for the team |
|---|---|---|
| Total artificial heart | Replaces the pumping ventricles and their valves. | Why is replacement of both pumping chambers being considered? |
| Ventricular assist device | Helps the existing heart pump blood. | Would an assist device meet the treatment goal? |
| Pacemaker or ICD | Provides electrical rhythm treatment. | Which rhythm problem is it intended to address? |
| Heart transplant | Replaces the diseased heart with a donor heart. | What assessment and waiting-list arrangements apply? |
NHLBI's overview of heart treatments explains the roles of assist devices, pacemakers and transplantation. For electrical rhythm treatment, see the separate implantable-defibrillator guide.
Ask what the treatment is intended to achieve
“Bridge to transplant” means providing support while a person waits for transplantation. Ask whether transplant eligibility is established, which assessments remain, and what could change the plan. The team's evaluation includes the severity and pattern of heart failure, other organ function, anatomy and ability to manage the treatment.
The FDA's original 2004 SynCardia CardioWest approval was for bridge-to-transplant use in transplant-eligible patients at risk of imminent death from failure of both ventricles. The FDA record also warns that supplements can change device information. Ask for the current labeling of the exact system proposed for you and whether the use is approved or part of a clinical trial in your country.
New-device announcements, trial participation and routine availability are separate statuses. If a trial is proposed, ask about its purpose, eligibility, alternatives, follow-up obligations and what is known versus still being studied. A news story about an implant does not answer those patient-specific questions.
Discuss the difficult outcomes explicitly
Ask what improvement is reasonably expected, the major risks of surgery and ongoing support, and the consequences of choosing another path. Important discussions include bleeding, clotting, infection, stroke, device problems and the possibility that transplantation may not occur. NHLBI's surgery and recovery information provides a starting point for that conversation.
Ask the team to explain its own experience with comparable patients. Agree who will revisit goals if recovery is difficult or eligibility changes. Include the patient's priorities, caregiver capacity and emotional support needs alongside technical suitability.
Plan daily life around the complete system
A portable driver can make movement and discharge possible for selected stable patients. The FDA's Freedom driver approval describes that specific bridge-to-transplant population. Discharge depends on clinical stability, training and a workable support plan.
NHLBI's living-with guide describes ongoing appointments, medicines and blood testing, infection prevention, battery and equipment teaching, and attention to device updates. Your team must demonstrate the actual routine and emergency response. Do not change equipment or medicine settings using general online instructions.
- Identify who must complete caregiver training and how competence is checked.
- Confirm power, backup equipment, supplies and a round-the-clock clinical contact.
- Discuss transport, distance from the center, home support and financial arrangements.
- Keep the device identification and emergency plan available to other clinicians.
Practice explaining the plan back to the team before any transition home. Use a portable health summary for contacts and current treatment details, while keeping the full device instructions close at hand.
A resource for the conversation
Save the total artificial heart: family discussion and support questions (editable text). Fill it in with the responsible team and keep your completed copy privately.
General patient education. Follow your clinical team's instructions for your care. Explore the medical guides.