The University of Southampton

Author: Eleanor Egaru

Total Artificial Heartbreak: An Impermanent Solution to Heart Failure

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The SynCardia Total Artificial Heart

Heart failure is a condition that affects over 1 million people in the UK. According to the British Heart Foundation, around 200,000 people are diagnosed with the condition every year. The condition tends to be managed through medications or through various surgical interventions, depending on the cause of the heart failure. However, in severe cases, these interventions may not be effective and a heart transplant may be the only option. As the waiting list for donor organs continues to grow, the medical world has been desperate to find another option.

Artificial hearts, once nothing more than an idea in the realm of science fiction, are now an exciting reality. Ventricular assist devices supplement the function of failing hearts by replacing one aspect of the heart, whereas total artificial hearts are created to replace the heart entirely.

The company SynCardia has created the first commercially approved total artificial heart. This innovative device replaces the ventricles and 4 valves of the heart. It offers hope and an extended life expectancy to patients with end-stage heart failure. The longest a patient has lived with a SynCardia total artificial heart is 6 years and 9 months.

The soft artificial heart prototype by ETH Zurich

An intriguing current prototype for a soft artificial heart is being researched by ETH Zurich. It is formed from silicone and was created using 3D bioprinting, in an attempt to mimic the human heart as closely as possible in its form and functionality. However, this heart has a lifetime of only 3,000 pumps – the equivalent of 30-45 minutes.

Despite these incredibly impressive innovations, there is a clear problem; artificial hearts have been created as a bridge to a donor heart transplant, and the code has not yet been cracked on how to create a permanent artificial heart.

One of the greatest difficulties is creating a device that can meet the demands of the heart. Total artificial hearts must pump 8 litres per minute of blood with a blood pressure of 110mmHg, which requires an enormous amount of power. (More statistics on requirements in this article) Additionally, the procedure may lead to infection and there are other devastating side effects. A functioning heart is an essential part of life; the creation of a permanent artificial heart replacement would undoubtably change the lives of millions worldwide.

One of those lives could potentially be mine. Heart failure is a condition that has impacted my family and is something that I am at higher risk of. It is comforting to know that there are many interventions in place for the condition, should I be in the position of needing them. The fear of needing a heart transplant is one that I think about at times. I hope to make an impact in the research of artificial hearts in future. When taking the issues with durability, infection risk and economic barriers into consideration, it seems as though the creation of a permanent, accessible artificial heart replacement is an idea of the distant future. But I like to view things optimistically; technology is advancing extremely quickly – perhaps there will be a breakthrough sooner than it is believed.

Cochlear Implants: An Advancement or Ableist?

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Hearing loss, whether congenital or developed later in life, affects many people. 1 in 5 adults in the UK experience hearing loss, are deaf or have tinnitus. More widely, 5% of the world’s population experience disabling hearing loss. Hearing, in conjunction with the other 4 senses, aids us in our understanding and interpretation of the world around us. So you would think that anything that helps to restore hearing is a net positive, right?

Not exactly.

There is a divide in the deaf community. Some see their deafness as a medical condition, whereas others see it as a cultural identity. The former group tend to see cochlear implants as a beneficial advancement and a great option as it can potentially improve their condition. Those who fall into the latter category tend to believe that cochlear implants are inherently negative, as the promotion of them implies that deafness is something that needs to be fixed. The deaf community have their own way of communicating that has been developed over many years, and the mass adoption of cochlear implants may cause them to lose the language and culture they have developed.

Cochlear implants are beneficial, with a 2020 study in adults showing that word recognition improved from 8.3% to 53.3% after implantation. However, it requires a lot of work for the person wearing the implant to reach this point. They will have to undergo speech and language therapy, and it can take many years to adjust to. The implant also does not restore hearing in the same way that non-deaf people can hear, as some may believe.

Below is a thread from an X/Twitter user, discussing how people without hearing loss may be insensitive to the emotions and agency of deaf people surrounding their choice of whether or not to use cochlear implants. The comments are taken from a video of a child who did not want to wear her implant after her parent asks her to put it on, and requests for her parent to sign with her instead.

In the thread, the user shares screenshots of people making comments such as, “If she didn’t want it she should pay her folks back for it”, and “Everyone cannot sign. She needs to be flexible and adaptable to make it in this world”, with many comments using ableist language.

With comments and language such as this, it’s understandable why there are deaf people who advocate for children to not be allowed to have cochlear implants until they can consent to the procedure.

The comments also display misconceptions about cochlear implants. There is a rampant attitude of “If you have an implant, why should I use sign language?” The consensus is that the child is choosing to not wear her implant out of insubordination. It is common for deaf people with hearing aids or implants to want “hearing breaks”. Some people with an implant still use lipreading and sign language as they may find it easier for many reasons.

This situation highlights the main issue that some deaf people have with cochlear implants; they can be seen as an excuse for the lack of accommodations that society has for deaf people.

Overall, cochlear implants are not a miracle cure. They have the potential to help deaf people, but it is an emotionally taxing process and it is not fair to expect all deaf people to want one (or two). If someone has a cochlear implant, but doesn’t want to use it all the time, we should be empathetic to that.