Written by Evan MacLure '26
Edited by Jasmine Shum '24
Ba-dup ba-dup. This is the sound of the very organ that makes everything else about us function. The organ that keeps us alive. But what if that organ falters as a result of heart disease, high cholesterol, or environmental factors? Currently, 7.2% of the US population suffers from coronary heart disease, the most common heart disease, with 697,000 dying in just 2020 alone [1]. Heart disease results from years of lifestyle, environmental, diet, or genetic factors that can possibly develop over time, with no sign of a cure. So what are these millions of people to do?
Heart transplants are a common procedure that is done to replace a failing heart with one from an organ donor who has recently passed away. The replaced heart is connected to all the main arteries and veins to continue the circulation of blood in the body. Roughly 2,000 people undergo heart transplants per year and about half live ten or more years [2]. Once heart disease reaches a severe threshold where the heart physically struggles to pump enough blood through the body, heart transplants are a necessary procedure to increase life expectancy. However, since heart transplantation is dependent purely on human supply through the use of organ donors, there are not nearly enough hearts to sustain a growing world population. In the last couple of years, there have been only about 6,000 donors worldwide [3][4]. This creates huge wait times for heart disease patients who are living on a ticking clock. Additionally, as chronic disease and other co-morbidities increase within the US population, it also affects the quality of the supply of hearts being transplanted which raises conflict on whether the benefits of heart transplants outweigh the costs [3].
Looking past the limited supply of human donors, doctors have investigated more artificial means to increase the supply of hearts to make it more widespread for recipients. While scientists have already started creating artificial organs with kidney dialysis for renal disease, for example, bioengineering a heart is unfortunately more complex as it is essentially a pump that works 24/7 at varying physiological rates depending on human activity.
Since the 1950s, humans have been trying to engineer hearts, but mainly as last resort alternatives while waiting for a heart transplant from an available donor [5]. The artificial hearts mainly consisted of a pump that would essentially stimulate blood flow in the body at a consistent rate, limiting activity for the individual at hand. A pump that needed to continue to beat roughly 10 million times a year. This is an exorbitant amount, and mechanical hearts usually begin to wear out far before even a diseased heart would through malfunctions or an inability to adapt to a changing physiological environment in a patient. With not much improvement to this technology for almost half a century, the future seemed pretty bleak for the innovation of artificial hearts [5].
This was until the BiVACOR mechanical heart was created in 2021, providing a new strategy of producing hearts. The device was not a high-tech mechanical pump with lots of wires and moving parts that could malfunction at any time, but a compact machine that uses a single rotating impeller that circulates blood returning to the heart and sends it out to the lungs and body [4]. Built on a MAGLEV magnetic system, which levitates the blood flowing into the device, the rotating impeller is prevented from significant mechanical wear over time, a significant downside to many of the past hearts that have been produced [4].
With its small compact size, the device even fits inside a child, increasing the viability of this product to the general population. But despite its size, allowing for a peak blood flow rate of 12 L/pm, a patient is not limited from pursuing daily activities and more active endeavors that require a significant increase in blood flow [4]. The device interacts with the blood flow of the body with a pressure-sensitive system to change the rotational speed of the rotary propeller to maintain homeostasis. In 1964, an artificial heart transplant was seen as a success when it lasted 64 hours, and current models last an average of 130 days. The BiVACOR heart is designed to last not days, but potentially over 10 years for transplanted patients [6].
This device is a viable alternative, lasting oftentimes longer than a donor's heart and being much more accessible to recipients in need. However, as it is still a prototype, it is crucial to find the limitations of the model through clinical trials. BiVACOR has tested initial clinical implants with patients waiting for organ donor heart transplants and cows to test blood flow efficiency in high intensity exercise [6]. The main question of the matter, however, is the cost if this device becomes available for widespread use. The average heart transplant with an organ donor costs over one million dollars [7]. Meanwhile, artificial transplants have a cheaper cost and are more efficient due to less resources and transportation costs and revolve around a price point of about $300,000 [8]. Recently, the company received $22 million in funding to begin testing their first human clinical trials to see the effectiveness of this new device [9]. Time will test the utilization of this product, and it will be interesting to see how development of this device proceeds in goals for the mainstream. Ba-dup…Ba-dup.
References
[1] CDC. Heart disease facts [Internet]. Centers for Disease Control and Prevention. Department of Health and Human Services; 2022 [cited 2022Dec11]. Available from: https://www.cdc.gov/heartdisease/facts.htm
[2] NHS. Heart Transplant [Internet]. NHS choices. Crown; 2019 [cited 2022Dec11]. Available from: https://www.nhs.uk/conditions/heart-transplant/
[3] Dharmavaram N, Hess T, Jaeger H, Smith J, Hermsen J, Murray D, et al. National trends in heart donor usage rates: Are we efficiently transplanting more hearts? Journal of the American Heart Association. 2021;10(15).
[4] BiVACOR. Replacing Hearts. Restoring Lives. [Internet]. BiVACOR. BiVACOR; [cited 2022Dec11]. Available from: https://bivacor.com/
[5] Ireland T. Artificial hearts made from magnets and titanium could save many lives [Internet]. BBC Science Focus Magazine. Immediate Media Company; 2021 [cited 2022Dec11]. Available from: https://www.sciencefocus.com/news/artificial-hearts-made-from-magnets-and-titanium-could-save-many-lives/
[6] Carey T. This artificial heart uses magnets and Spinning Disks to reinvent the heart [Internet]. Freethink. Freethink Media; 2021 [cited 2022Dec11]. Available from: https://www.freethink.com/health/this-artificial-heart-uses-magnets-and-spinning-disks-to-reinvent-the-heart
[7] West M. Heart transplant: How it works, cost, insurance, and more [Internet]. Medical News Today. MediLexicon International; 2022 [cited 2022Dec11]. Available from: https://www.medicalnewstoday.com/articles/heart-transplant-cost
[8] DP L. The artificial heart. costs, risks, and benefits--an update [Internet]. International journal of technology assessment in health care. U.S. National Library of Medicine; [cited 2022Dec11]. Available from: https://pubmed.ncbi.nlm.nih.gov/10311835/
[9] Park A. Bivacor lands $22m to begin human trials of its magnetic artificial heart [Internet]. Fierce Biotech. Questex; 2021 [cited 2022Dec11]. Available from: https://www.fiercebiotech.com/medtech/bivacor-lands-22m-venture-capital-and-nih-funds-to-begin-human-studies-artificial-heart
[IMAGE] Carey, This artificial heart uses magnets and spinning disks to reinvent the heart
2021, Date range. Photo of BiVACOR metal heart. Freethink.