Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhDThe Total Artificial Heart Where Are We?Arabía, Francisco A. MD, MBA, FACS, FACC*,†Author Information From the Departments of *Surgery †Medicine, Banner-University of Arizona, Phoenix, AZ. Disclosure: F.A.A. is a consultant to SynCardia Systems, Carmat SA, and BiVACOR, Inc. Correspondence: Francisco A. Arabía, MD, MBA, FACS, FACC, Departments of Surgery and Medicine, Banner-University of Arizona, 1111 East McDowell Rd, Phoenix, AZ 85006. E-mail: email@example.com. Cardiology in Review: November/December 2020 - Volume 28 - Issue 6 - p 275-282 doi: 10.1097/CRD.0000000000000322 Buy Metrics Abstract The total artificial heart (TAH) is a device that replaces the failing ventricles. There have been numerous TAHs designed over the last few decades, but the one with the largest patient experience is the SynCardia temporary TAH. The 50-mL and 70-mL sizes have been approved in the United States, Europe, and Canada as a bridge to transplantation. It is indicated in patients with severe biventricular failure or structural heart issues that preclude the use of a left ventricular assist device. The majority of the patients implanted are Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2. The 1-year survival in experienced centers that have implanted over 10 TAHs is 73%. The risk factors for death include older age, need for preimplantation dialysis, and malnutrition. The most common causes of death are multiple organ failure, usually the result of physiologic deterioration before implantation, and neurologic dysfunction. The device allows the patient to be discharged home and managed as an outpatient. Proper patient selection, the timing of intervention, patient care, and device management are essential for a suitable outcome. In addition, the CARMAT TAH is another device that will soon be studied in a clinical trial in the United States. The BiVACOR TAH is a revolutionary design utilizing electromagnetic levitation that is expected to enter a clinical trial in the next few years. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.