The total artificial heart: An existential transformation beyond technology

The concept of the total artificial heart (TAH) has long fascinated humanity, between the quest for immortality and the fear of dehumanization. Previous generations of TAH were marred by thrombotic and haemorrhagic complications, tethering patients to the hospital,¹ offering at best a few weeks of reprieve.

The new generation Aeson TAH (Carmat SA, Vélizy, France) is now a lifesaving and life-changing therapeutic option for end-stage heart failure patients with severe irreversible biventricular dysfunction. With the shortage of organ donors and the growing number of end-stage heart failure patients, a machine capable of replicating the complex function of the human heart, tireless and silent, automated but innervated, capable of adapting to the needs of the human body is a transformative advance in care. Conceptually disruptive and audacious, the Aeson TAH has been the subject of scientific studies, media coverage and financial analyses so far, with a reflection based on clinical outcomes, statistics and economic profitability. However, being implanted with a TAH cannot merely reflect this scientific revolution. It is a profound intimate transformation that raises existential, societal, and ethical questions. Amid the technology, data, and parameters, who thinks about the lives of these women and men now living without a natural heart? What do these patients think of this transhumanist dream they are turning into reality? What are the impacts for patients, society, and humanity?