Surgical implantation of the CardioWest Total Artificial Heart.

The CardioWest Total Artificial Heart (CW-TAH) is a pneumatically driven pump that completely replaces the patient’s native ventricles orthotopically. The device weighs 160 g and consists of two artificial ventricles, four Medtronic Hall tilting disk valves, two membranes, and two drivelines tunneled through the skin, which connect the ventricles to an external console generating pulsatile flow (1). At maximum stroke volume (close to 70 mL), it delivers a cardiac output between seven and nine litres per minute. Variations in cardiac output are determined by variations in venous return and peripheral resistance linked to the patient’s position and level of physical activity (2). The CWTAH is indicated for use in patients with refractory cardiac failure as a bridge to transplantation, and when used for this indication, improves survival to transplant (3). Portable drivers have been approved in both Europe and the United States to allow stable patients to be discharged home while awaiting their transplant (4).