What is an Artificial Heart: Pulsating Hope or Fictitious Dream?

The heart is one of the main organs in the human body responsible for pumping blood through the circulatory system. Any failure in this system can lead to fatal outcomes. Hence, scientists have been pouring their efforts into finding alternatives for human heart transplantation to combat the shortage of heart donors. One such alternative is the invention of an artificial heart. The idea of creating an artificial heart has been in the works for more than half a century. But what exactly is an artificial heart, and how does it work? Is it a viable option for heart patients? Let us explore this topic further.

What is an artificial heart?

An artificial heart is a mechanical device that is implanted in the body to replace the failing or diseased natural heart. It serves to pump blood throughout the body to maintain the life and health of the patient. There are two types of artificial hearts:

1. Total Artificial Heart (TAH)

TAH is an implantable device that replaces the entire heart. It consists of two pumps, one for each ventricle, and is connected to both the patient’s atria and blood vessels. The pumps are typically driven by an external pneumatic system that pumps the air into the artificial heart, thus offering the heart’s necessary force to pump blood. The TAH requires a person to use a power source such as a portable driver, which powers the external air compressor.

2. Ventricular Assist Devices (VAD)

VADs are devices that help a failing heart that is unable to pump blood effectively. VADs are not a complete replacement of the natural heart but work alongside the natural heart to help it better pump blood. VADs can be used for a single ventricle or both. VADs typically have a small electronic pump attached to the healthy portion of the heart. That pump is connected to a small controller which consists of batteries and electronics, outside of the body.

How does an artificial heart work?

An artificial heart works by mimicking the heart’s functioning, i.e. pumping blood to the body’s vital organs. It does this by using a motor-powered pump to push blood through the circulatory system. The blood is moved from the chambers of the artificial heart to the lungs to take in oxygen, then back to the heart chambers. The heart chambers then send the oxygen-rich blood to the rest of the body through the arteries.

The TAH is designed to take over the complete functioning of the natural heart, whereas VAD supports the natural heart’s pumping action. The VAD consists of an inflow cannula that draws blood from the natural heart’s weakened or damaged ventricle and moves it to an outflow cannula that advances the blood to the aorta. The VAD’s electronic controller monitors the pump’s speed and ensures that the blood’s flow rate is steady, irrespective of the patient’s activity level. In contrast, the TAH uses a pneumatic system, which relies on precise timing and carefully balanced pressures to ensure that blood is moving to and from the heart efficiently.

History of artificial heart development

The idea of creating an artificial heart and transplanting it to save the human heart was first introduced in the 1960s when doctors could only build external heart pumps used to support the heart of people who have suffered heart failure. In 1967, Dr. Christiaan Barnard performed the first human heart transplant. Since then, heart transplantation has developed into a standard and successful medical procedure. However, heart transplant operations are limited by the availability of donor organs. Hence, artificial heart technology has developed as a potential alternative to heart transplantation.

In 1982, the first total artificial heart (TAH) was implanted in the body of Seattle dentist Barney Clark, who lived with the device for 112 days before passing due to multiple organ failure. Since then, several medical institutions and companies have worked relentlessly to improve the TAH, making it smaller, portable, less invasive and more efficient. In recent years, the development of VADs has progressed so much that they are becoming more and more commonplace for heart patients seeking alternatives to transplantation.

The impact of artificial hearts on cardiac patients’ lives

The artificial heart’s impact on the lives of cardiac patients cannot be overemphasized. Patients with artificial hearts have a new lease of life, free from the worry of dependence on heart transplantation, which might not be readily available. Artificial hearts have become a credible pathway to recovery and to regain a good quality of life.

Beyond keeping cardiac patients alive, artificial hearts play a critical role in advancing the development of extracorporeal cardiopulmonary bypass technology, which has demonstrated potential in reducing deaths particularly in acute HS (heart failure) patients while waiting for donors. This is crucial because acute HS is usually an unexpected event, leaving little time for medical intervention, which renders the condition fatal.

Challenges associated with artificial hearts

Despite the potential of artificial hearts, there are several challenges facing the implementation of these devices. One of the significant challenges is the high chance of post-implantation complications such as bleeding, infection, and clotting. Therefore, patients with artificial hearts require lifelong management under the care of specialized medical teams. Artificial hearts are also very expensive, making them inaccessible to many people. Besides, as small as VADs and TAH may be, they require considerable surgical interventions in a delicate organ such as the heart. This makes their implantation and maintenance technically challenging and expensive.

The Future of Artificial Hearts

Several companies and institutions are continuously working on improving the technology of artificial hearts. The latest development is the Ambulatory Total Artificial Heart (ATAH), which does not need connectors and could be attached to the aorta only. It eliminates the air compressor-based external driver making it possible for the patient to live without an external device. This research presents a brighter future for artificial hearts as this technology would mean a more affordable and comfortable way for patients to live and manage their heart conditions. However, more research is required for the latest development before it becomes available to the general public.

Conclusion

In conclusion, artificial hearts have come a long way in development since the idea was first introduced. The advancements in technology have brought about a significant change in the lives of patients living with heart conditions. Artificial hearts have continued to develop from the bulky TAHs with limited functionality to VADs that assist the human heart with minimal surgical intervention today. With continued research and improvement in the technology behind the VAD and TAHs, artificial hearts hold promise and are increasingly becoming a credible alternative to heart transplantation.

FAQs

  • 1. What is an artificial heart?
  • An artificial heart is a mechanical device that is implanted in the body to replace the failing or diseased natural heart. It serves to pump blood throughout the body to maintain the life and health of the patient.

  • 2. How does an artificial heart work
  • An artificial heart works by mimicking the heart’s functioning, i.e. pumping blood to the body’s vital organs. It does this by using a motor-powered pump to push blood through the circulatory system. The blood is moved from the chambers of the artificial heart to the lungs to take in oxygen, then back to the heart chambers. The heart chambers then send the oxygen-rich blood to the rest of the body through the arteries.

  • 3. What are the different types of artificial hearts?
  • There are two types of artificial hearts. They are Total Artificial Heart (TAH) and Ventricular Assist Devices (VAD).

  • 4. What challenges are associated with artificial hearts?
  • The significant challenges associated with artificial hearts include high rates of post-implantation complications, lifelong management needs, technical expertise for implantation and maintenance, and expenses of the devices.

  • 5. What is the future of artificial hearts?
  • The future of artificial hearts is promising, and research and development are ongoing to improve the technology behind the hearts. The latest development is the Ambulatory Total Artificial Heart (ATAH), which eliminates the external driver making it possible for the patient to live comfortably and affordably.

References

  • Frazier, O. H., & Jarvik, R. K. (2019). Total Artificial Heart. StatPearls [Internet].
  • Kulkarni, A., & Tole, S. (2016). Artificial heart. APIK Journal of internal medicine.
  • Tchantchaleishvili, V., & Umakanthan, R. (2018). Artificial heart technologies: current challenges and future prospects. Medical Devices (Auckland, NZ), 11, 205–214. https://doi.org/10.2147/MDER.S131697
  • Greene, K. (2015). Remembering Dr. Christiaan Barnard, First Surgeon to Perform a Heart Transplant. History.com.

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