Heart Transplant or Total Artificial Heart
Lacey Clement
Western Governors University

Cardiovascular diseases are responsible for roughly 600,000 deaths each year, making heart disease the leading cause of death in the United States (Centers for Disease Control and Prevention, 2012). There are many types of heart conditions and diseases that have required medical professionals to develop and trial new procedures, devices, and forms of treatment. This presentation focuses on two surgical procedures used to treat end stage heart disease. These procedures are traditional heart transplants and total artificial heart devices. Research shows that traditional heart transplants are a better surgical option for patients in end stage heart disease because transplants offers a higher chance of long term success, replace the whole heart rather than half to improve systemic function, require no power sources that restrict patient activity, and involve more management complications compared with artificial heart devices.
Research also indicates the many heart transplants are possible because artificial heart procedures give patients time when waiting for a heart transplant. This is commonly referred to as bridge therapy; as the device is allowing patients who are in a critical state to sustain life until a heart becomes available. The need for bridge therapy stems from the short supply of donor hearts and a high demand. Roughly 2,000 heart transplants are performed each year, while around 3,000 people are on the heart transplant list (Centers for Disease Control and Prevention, 2012). The average wait for a heart transplant is 6 to 12 months (Bowen, 2012). Some patients do not have that time, as 90 percent of all total artificial heart patients were in the two sickest categories, critical cardiogenic shock and progressive decline, before their procedures (SynCardia Systems, 2011). The artificial heart devices offer patients months while they wait. Traditional heart transplants offer patient years. The number of patients using bridge therapies increased from 19% in 2002 to 30% in 2009. A study conducted of transplant patients estimates fifty percent of transplant patients have on average eleven years. Patients of who survived the first year, increased to an average of fourteen years. Several of the patients in the study have lived twenty-five years from their transplant date (Stehlik, 2011).
These time variations are linked to the surgical aspects of these procedures. A total artificial heart involves replacing the ventricles or lower cambers of the heart. The ventricles are responsibly for pushing the blood throughout the body. Replacing only the ventricles means that the remaining parts of the disease, native heart are still required to function, and the device must rely on a power source to ensure proper and continuous function. There are many different types of total artificial hearts and ventricle assist devices. The Abiocor is an example of a total artificial heart that implants the power source into the abdomen. This increases surgical risks, and requires additional surgery to manage and maintain the power source. The Cardio West is an example of devices that connects an artificial heart to the external power source by a drive line which is tunneled through the skin (U.S. Department of Health & Human Services, 2012). The patient must be constantly aware of the battery life, placement, and proper handling of the power sources (U.S. Department of Health & Human Services, 2012). These power source components can limit daily actives and restrict the patients from some activates such as swimming or taking a bath.
Transplants replace the diseased heart with a donor heart, by “transecting the aorta, the main pulmonary artery and the superior and inferior vena cavae, and dividing the left atrium, leaving the back wall of the left atrium with the pulmonary vein openings in place” (American Heart Association, 2011). The donor