Total Artificial Heart as the Destination Therapy: A Review

Introduction: For the patients awaiting cardiac transplantation, mechanical circulatory support has been widely utilized in the form of left ventricular assist device or total artificial heart. Both total artificial heart and left ventricular assist device have been approved for the use as a bridge to transplantation therapy; however only left ventricular assist device has been approved for use as the destination therapy. The purpose of this review is to establish, using this literature, the possibility for the artificial heart transplant to be used as destination therapy besides highlighting the recent developments in this area of research in order to narrate the future of artificial heart transplantation. Review: 5 studies including 3 case reports, one retrospective multicenter study and one clinical trial were identified following a rigorous literature search. Four studies reported the outcomes related to SynCardia total artificial heart implantation whereas one study presented the results of the clinical trial conducted for the AbioCor total artificial heart. Although total artificial heart has established the reputation of a successful device for bridge to transplantation therapy, attempts have been made for the implantation of total artificial heart as destination therapy to provide a replacement of failing human heart. Conclusion: A limited pool of studies is available regarding the usage of total artificial heart as the destination therapy that has shown promising results, but numerous issues like biocompatibility, durability, reliability of power supply, dependency on external console for power, and control of complications including thromboembolism, hemorrhage and infections remain imminent challenges for the scientists that need to be addressed before total artificial heart can completely overtake the role of natural human heart. Keywords: Total Artificial Heart; Destination therap