Reader Response Draft #1

The article “Replacing Hearts. Restoring Lives.” (BiVACOR, n.d.) introduces the first long-term therapy for people with severe biventricular heart failure. BiVACOR’s Total Artificial Heart is a treatment option for individuals in the final stages of heart failure who require assistance while awaiting a heart transplant or are ineligible for transplantation. The BiVACOR system consists of a rotor suspended using advanced magnetic levitation (MAGLEV), positioned between opposing pump enclosures. Its central capability is to assist both the left and right sides of the heart, facilitated by impeller blades for each side, attached to the revolving core. The core is elevated and set in motion through an electromagnetic motor and bearing configuration situated atop the pump enclosures. The impellers are specifically engineered hydraulically and, when coupled with MAGLEV technology, allow precise control over circulation adjustment through a differential fluid discharge. With advanced technology, The BiVACOR Total Artificial Heart is a clear improvement over SynCardia’s Total Artificial Heart in terms of its support time, material used, and the mechanism of the Artificial Hearts.

Pertaining to support time, BiVACOR provides a significantly longer support time as compared to Syncardia. The Syncardia Total Artificial Heart diaphragm, which pumps blood into and out of the ventricles, has demonstrated a failure rate of less than 1% in more than 1,000 implants (SynCardia, 2023), and the current longest duration of support after transplantation in a man is 3.75 years (Copeland, n.d.). On the other hand, with a lifespan of at least 10 years, BiVACOR’s Total Artificial Heart can last much longer because the rotating disk is able to levitate without causing mechanical wear or friction (Park, 2021). Although the failure rate of SynCardia’s heart is proven to be low, BiVACOR’s heart is shown to be able to provide at least twice the duration of support time.

Moreover, the material used for BiVACOR is way more durable as compared to SynCardia. A highly specialised segmented polyurethane solution is used for manufacturing the housings, diaphragms, and connectors for the SynCardia heart (SynCardia, n.d.). In the article “Plastics and the artificial heart” (Bregar, 2017), Dr. Billy Cohn mentioned that artificial hearts that use multisegmented polyurethane membranes that were fed air through hoses can carry bacteria that can infect the heart. On the contrary, the BiVACOR heart has almost no mechanical wear because of the high-tech rotary pump's levitation between magnets. The rest of the heart may be made from ultra-robust titanium because it has no other moving parts (Ireland, 2021). Hence, with the advancement from plastic to metal, the BiVACOR heart reduces the rate of infection and is proven to be longer-lasting than SynCardia’s.

Regarding mechanisms, BiVACOR’s heart runs on an electromagnetic mechanism while SynCardia’s heart runs pneumatically. Four valves and two biocompatible plastic ventricles make up the SynCardia heart. The internal chamber, where the blood flows, and the external chamber, where the pneumatic mechanism runs, are separated by a diaphragm in each ventricle (SynCardia, 2023). Conversely, the BiVACOR heart uses a spinning disc suspended in a magnetic field rather than a mechanical pump that replicates the four chambers of the human heart. The heart only has one working part, which allows it to pump oxygen-rich blood out to the body and return blood that is low in oxygen to the lungs (Greatrex et al., 2019). Thus, with the use of electromagnetism in the BiVACOR heart, the advanced mechanism could potentially lead to better durability of the device.

However, a major concern regarding the BiVACOR heart is that it has yet to be approved by the Food and Drug Administration (FDA). The SynCardia Total Artificial Heart is the first biventricular cardiac replacement approved by the FDA for bridge to transplantation and holds the European Union CE mark. It is a tried-and-true device for recovering potential transplant candidates who rapidly decompensate from biventricular failure or who have chronic heart failure (Copeland et al., 2021). This would cause the BiVACOR heart to lose out when it comes to reliability. Nonetheless, with great advancements in the device, there is a high probability that the BiVACOR heart will be FDA-approved in the near future.

In conclusion, with the significant contrast in the support time, durability of the materials used, and the advanced mechanism used in the devices, BiVACOR’s Total Artificial Heart shows superiority over SynCardia’s Total Artificial Heart.

References

BiVACOR. (n.d.). BiVACOR. Retrieved September 18, 2023, from https://bivacor.com/

Bregar, B. (2017, July 6). Plastics-and-the-artificial-heart. Plastics News. Retrieved September 26, 2023, from https://www.plasticsnews.com/article/20170706/NEWS/170709964/plastics-and-the-artificial-heart

Copeland, J., Langford, S., Giampietro, J., Arancio, J., & Arabia, F. (2021, June 28). Total Artificial Heart Update. PubMed. Retrieved September 27, 2023, from https://pubmed.ncbi.nlm.nih.gov/34181241/

Copeland, J. G. (n.d.). SynCardia Total Artificial Heart - PMC. NCBI. Retrieved September 26, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853833/

Greatrex, N., Kleinheyer, M., Nestler, F., & Timms, D. (2019, September). The Maglev Heart. IEEE Spectrum. Retrieved September 26, 2023, from https://spectrum.ieee.org/this-maglev-heart-could-keep-cardiac-patients-alive

Ireland, T. (2021, July 4). Artificial hearts made from magnets and titanium could save many lives. BBC Science Focus. Retrieved September 26, 2023, from https://www.sciencefocus.com/news/artificial-hearts-made-from-magnets-and-titanium-could-save-many-lives

Park, A. (2021, May 20). Bivacor lands $22M to begin human trials of its magnetic artificial heart. Fierce Biotech. Retrieved September 26, 2023, from https://www.fiercebiotech.com/medtech/bivacor-lands-22m-venture-capital-and-nih-funds-to-begin-human-studies-artificial-heart

SynCardia. (n.d.). GIVE PATIENTS THE GIFT OF TIME. SynCardia. Retrieved September 26, 2023, from https://syncardia.com/total-artificial-heart-50-cc-and-70-cc/

SynCardia. (2023, March 20). Syncardia Total Artificial Heart - Mercé V. Electromedicina. Mercé Electromedicina. Retrieved September 26, 2023, from https://mercev.com/en/heart-failure-syncardia/