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An Australian man in his forties has become the first person in the world to leave hospital with an artificial heart made of titanium. The device is used as a stopgap for people with heart failure who are waiting for a donor heart, and previous recipients of this type of artificial heart had remained in US hospitals while it was in place.

The man lived with the device for more than three months until he underwent surgery to receive a donated human heart. The man is recovering well, according to a statement from St Vincent’s Hospital in Sydney, Australia, where the operations were conducted.The Australian is the sixth person globally to receive the device, known as BiVACOR, but the first to live with it for more than a month.

“This is certainly an important development in the field,” says Julian Smith, a cardiac surgeon at the Victorian Heart Institute at Monash University in Melbourne, Australia.

“It is incredibly innovative,” says Sarah Aitken, a vascular surgeon at the University of Sydney, but she adds that there are still many unanswered questions about the level of function that people with it can achieve and the ultimate cost of the device. “This kind of research is really challenging to do because it is very expensive” and the surgery involved is very high-risk, says Aitken.

The latest success will help researchers to understand how people cope with this device in the real world, says Joseph Rogers, a heart-failure cardiologist and president of the Texas Heart Institute in Houston. “They weren’t being constantly monitored by medical teams,” says Rogers, who led the first trial of the device in the United States last year.

In all cases, the BiVACOR was used as a temporary measure before a donor heart became available. Some cardiologists say that it could become a permanent option for people not eligible for transplants because of their age or other health conditions, although the idea still needs to be tested in trials. In the United States, close to 7 million adults live with heart failure, but only about 4,500 heart transplants were performed in 2023, in part because of a shortage of donors.

Suspended rotor

BiVACOR was invented by biomedical engineer Daniel Timms, who founded a company named after the device, with offices in Huntington Beach, California and Southport, Australia.

The device is a total heart replacement and works as a continuous pump in which a magnetically suspended rotor propels blood in regular pulses throughout the body. A cord tunnelled under the skin connects the device to an external, portable controller that runs on batteries by day and can be plugged into the mains at night.

Many mechanical heart devices support the left side of the heart, and typically work by pooling blood in a sack, which flexes some 35 million times a year to pump blood. But these devices have many parts and often suffer failures. BiVACOR, which only has one moving part, will in theory experience fewer problems of mechanical wear, says Rogers.

US trials

The Australian recipient of BiVACOR had severe heart failure, and received the titanium device in a six-hour operation in November. In February, he was discharged from hospital, stayed in a residence close by and led a relatively normal life. In March, he received a donor heart.

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