The artificial heart – how far science has reached in 2026
From a temporary heart replacement to a fully implantable bionic heart
The human heart is one of the most important organs in the human body. It works continuously from the moment of birth until the end of life, pumping blood to the lungs and all other organs.
In severe heart failure, modern medicine has several types of mechanical circulatory support, including devices that support the work of one chamber, as well as total artificial hearts, which replace the pumping function of the two heart chambers.
For many years, the main purpose of the total artificial heart was to keep the patient alive until a donor heart could be found.
In recent years, however, a new generation of technology has emerged.
Researchers are already developing artificial hearts that are smaller, quieter, more efficient and potentially can be fully implanted in the human body.
A particularly important example is BiVACOR Total Artificial Heart – an artificial heart with a magnetically levitating rotor and only one moving part. The first human implantation took place in July 2024 as part of a clinical trial in the US. (BiVACOR, Inc.)
As of 2026, however, there is still no artificial heart approved for permanent, lifelong replacement of the natural human heart.
How does the human heart work?
The human heart has four chambers:
- right atrium;
- right chamber;
- left atrium;
- left chamber.
The right half of the heart pumps blood to the lungs, where it is enriched with oxygen.
The oxygenated blood is then returned to the left half of the heart.
The left ventricle pumps blood to the whole body.
This looks like a relatively simple mechanical pump, but in fact the heart is an extremely complex biological system.
It must continuously regulate:
- heart rate;
- pumping power;
- the amount of blood;
- the pressure;
- the time between contractions;
- the reaction to physical exertion;
- the response to rest and sleep.
The natural heart also works closely with the nervous and hormonal systems.
Therefore, creating a mechanical pump that simply moves the blood is not enough.
It is necessary for the device to be able to maintain blood circulation under the constantly changing conditions in the human body.
What is a total artificial heart?
The total artificial heart, or Total Artificial Heart (TAH), is a device that replaces the pumping function of the natural ventricles.
This distinguishes it from LVAD – Left Ventricular Assist Device.
The LVAD assists the left ventricle.
A total artificial heart replaces the functions of the ventricles.
This is especially important in patients with severe biventricular heart failure.
SynCardia Total Artificial Heart
One of the most important stages in the history of the artificial heart is SynCardia Total Artificial Heart.
It is the first artificial heart to receive FDA approval for clinical use.
As of 2026, SynCardia remains the only total artificial heart approved for commercial use in the US and Canada. (syncardia.com)
The system replaces the ventricles and uses a pneumatic mechanism to pump the blood.
The implanted part is connected by tubing to an external pneumatic driver.
The system can use the sick leave Companion 2 Driver, and in suitable patients and portable Freedom Driver. (syncardia.com)
This allows some patients to be mobile outside the hospital while waiting for a transplant.
But there is a significant drawback.
Part of the system remains outside the body.
Therefore, SynCardia is not a fully implantable artificial heart.
How long can an artificial heart work?
An update to the old article is needed here.
It is not correct to simply say that an artificial heart can work “less than a year”.
Duration depends on the specific system, patient and clinical situation.
SynCardia is primarily intended as bridge-to-transplant – temporary support until a donor heart transplant. (syncardia.com)
At the same time, clinical experience shows that patients can be maintained significantly longer than a few weeks.
For example, in 2024, a BiVACOR artificial heart was implanted in a patient with severe heart failure in Australia.
The patient was subsequently discharged from the hospital with the artificial heart and lives with it 105 days, before a donor heart transplant is performed. (Monash University)
This is an important demonstration that new technologies can provide long-term mechanical support outside the hospital environment.
BiVACOR – a new concept for an artificial heart
One of the most interesting developments in recent years is BiVACOR Total Artificial Heart.
Unlike traditional total artificial hearts, BiVACOR uses an electromechanical rotary pump.
The device is made of titanium and has one magnetically levitating rotor, which pumps blood to the lungs and systemic circulation.
Thus, the device does not have the traditional valves and flexible membranes characteristic of pneumatic systems. (BiVACOR, Inc.)
This is a fundamentally different engineering concept.
The first BiVACOR implantation in a human
On July 9, 2024 The Texas Heart Institute performs the first implantation of the BiVACOR Total Artificial Heart in a human.
The procedure was performed on a patient with end-stage heart failure.
The goal of the early clinical trial is to evaluate the safety and performance of the system as a bridge to transplantation. (BiVACOR, Inc.)
This is an important moment because it shows that the technology has already moved from laboratory and animal studies to clinical use in humans.
The first BiVACOR patient discharged from the hospital
In November 2024, BiVACOR was implanted in a patient at St Vincent’s Hospital Sydney.
After several weeks in the intensive care unit and follow-up, the patient became the first person in the world to be discharged from the hospital with a BiVACOR Total Artificial Heart.
He spends 105 days with the device, before a suitable donor heart is found.
On March 6, 2025, the patient received a human heart transplant. (Monash University)
This is one of the most significant practical results in the development of modern total artificial hearts.
What makes BiVACOR different?
BiVACOR has several features that distinguish it from traditional pneumatic artificial hearts.
Magnetic levitating rotor
The rotor is supported by magnetic levitation.
This reduces mechanical contact between moving parts.
Only one moving part
All pumping is done by one rotor.
No traditional mechanical valves
Blood flow is generated by the rotation of the rotor.
Replaces both ventricles
The system can perform the functions of the right and left ventricles.
Small size
The design was developed so that it could be placed in the human chest.
This opens up the possibility of future systems that are much smaller and less dependent on external hardware.
BiVACOR is not yet a permanent artificial heart
This is a very important clarification.
Despite the impressive results, BiVACOR is still clinical experimental technology.
The company is conducting an early FDA-approved clinical trial to evaluate the safety and effectiveness of the system as a bridge to transplantation. (BiVACOR, Inc.)
Therefore, we cannot say that BiVACOR has already replaced the human heart permanently.
But we can say that technology represents an important step towards this goal.
Aeson – an artificial heart with a biomimetic approach
Another important project is Aeson, developed by the French company CARMAT.
Aeson has a different concept.
Instead of just using a mechanical rotary pump, the system aims to mimic more of the characteristics of the natural heart.
It uses mechanical cameras and sensors that allow regulation of blood flow according to the patient’s needs.
Aeson receives CE marking in Europe for use as a bridge to transplantation, and in 2025 it also receives CE certification under the European MDR. (SEC)
As of January 2026, a post-marketing clinical trial is ongoing to track the safety, effectiveness and duration of maintenance with Aeson until transplantation. (ICHGCP)
This indicates that Aeson has reached a significantly more advanced stage than pure laboratory technology.
Aeson and CARMAT problems
The development of the artificial heart is not only a medical and engineering problem.
It is also a production and economic problem.
CARMAT entered financial restructuring procedures in 2025, which led to a reduction or temporary suspension of some of the new implantations.
At the end of 2025, a French court approved the transfer of certain assets to a new company, CARMAT SAS. According to corporate filings from 2026, clinical development and support for existing patients continues, but the future of large-scale production remains a complex question. (SEC)
This example shows how difficult it is for a high-tech medical system to move from clinical trials to sustainable mass production.
The next goal – a fully implantable artificial heart
One of the biggest problems with modern total artificial hearts is the presence of an external driver.
It means:
- external equipment;
- cables or tubes that pass through the skin;
- external battery;
- limited mobility;
- risk of infection;
- need for constant control.
Therefore, the ideal future artificial heart should be:
fully implanted in the body.
The Emperor Project
In 2026, SynCardia developed a new generation system called Emperor Total Artificial Heart.
The goal is to replace the pneumatic external driver with an electromechanical system that resides in the body.
According to data released in 2026, the Emperor uses an electromechanical actuator and is being developed as the basis for a future fully implantable system. (JACC)
A company update from 2026 states that prototypes of Emperor are in preclinical laboratory and animal trials and that, subject to successful results and regulatory review, the company could seek FDA approval for the system around 2028 (SEC)
This is an important clarification:
Emperor has not yet been implanted in humans as an approved permanent artificial heart.
It is a next generation technology under development.
What would a fully implantable artificial heart look like?
A future system could look something like this:
artificial heart
↓
internal electromechanical motor
↓
built-in battery
↓
wireless charging through the skin
↓
blood pressure and blood flow sensors
↓
automatic adjustment system
Such a device could operate without a permanent external pneumatic pump.
Artificial intelligence and the future heart
Artificial intelligence and control algorithms may play an important role in future artificial hearts.
An intelligent system could monitor:
- blood flow;
- the pressure;
- heart rate;
- physical activity;
- oxygen demand;
- body position;
- metabolic load.
The controller can then automatically change the operation of the pump.
For example, during physical exertion, the body needs more blood flow.
During sleep, the need is lower.
The natural heart makes this adaptation automatically.
One of the main goals of future artificial hearts is to achieve such automatic regulation.
Artificial heart versus transplanted human heart
An important distinction must be made here.
In the transplant, the patient receives a biological human organ.
In the total artificial heart, the biological organ is replaced by a mechanical system.
This eliminates the need for a donor heart, but creates other problems:
- mechanical wear;
- energy supply;
- thrombus formation;
- interaction between blood and artificial materials;
- infections;
- electronic failures;
- mechanical damage;
- need for control and monitoring.
Therefore, a permanent artificial heart must be more than just mechanically reliable.
It must be reliable over years or decades.
Can an artificial heart work for tens of years?
This is one of the greatest scientific goals.
For an artificial heart to replace a natural organ for life, it must pump blood continuously:
24 hours a day
365 days a year
for decades.
That means billions of cycles of operation.
In addition to mechanical reliability, the issue of energy must also be addressed.
The human heart receives energy from the body’s metabolism.
An artificial heart must be powered by a battery or other system.
Therefore, a future permanent artificial heart will likely need a combination of:
- highly efficient electric motor;
- high efficiency battery;
- wireless charging;
- intelligent energy management;
- minimal friction;
- minimal heating.
The main problem – the blood
One of the biggest problems with mechanical hearts is the interaction between the artificial surfaces and the blood.
Blood can react to foreign materials.
This can lead to:
- thrombus formation;
- damage to blood cells;
- inflammatory reactions;
- emboli.
Therefore, modern artificial hearts use special materials, geometries and methods to control blood flow.
Magnetic levitation in the BiVACOR, for example, allows the rotor to be supported without traditional mechanical contact, which is part of an engineering approach to reduce mechanical wear and optimize blood interaction. (BiVACOR, Inc.)
Can an artificial heart be better than a human one?
In the future, it is possible that the artificial heart will have functions that the natural organ does not have.
For example:
- constant monitoring;
- digital blood flow measurement;
- automatic adjustment;
- remote diagnostics;
- failure warning;
- AI control;
- smartphone integration;
- prediction of heart problems;
- automatic adaptation to physical activity.
In the future, it is possible that the system could even communicate with a medical center and automatically transmit diagnostic data.
However, these are future technological possibilities, not features of today’s clinically approved total artificial hearts.
The state of technology in 2026
| Technology | Status in 2026 |
|---|---|
| SynCardia Total Artificial Heart | Clinically used total artificial heart; bridge to transplantation |
| Freedom Driver | Allows portable maintenance in appropriate patients |
| Aeson | Clinically used in Europe for certain indications; post-marketing tracking |
| BiVACOR Total Artificial Heart | Early human clinical trial |
| BiVACOR 105-day case | The patient lived 105 days with the device until transplant |
| Emperor | Preclinical development of a next generation mechanical drive |
| A fully implantable artificial heart | Still under development |
| Permanent Lifetime Heart Replacement | Not yet achieved |
SynCardia remains the only total artificial heart with commercial approval in the US and Canada, while BiVACOR and the next-generation Emperor are in various stages of clinical and preclinical development. (syncardia.com)
What should be achieved?
In order to have a true permanent artificial heart, several fundamental problems must be solved.
1. Long-term reliability
The device should work for years or decades without mechanical failure.
2. Energy
A reliable power system with no permanent external connection is required.
3. Biocompatibility
Materials must interact safely with blood and tissues.
4. Automatic control
The artificial heart must respond to the body’s needs.
5. Miniaturization
The device must be small enough to be placed safely on the chest.
6. Wireless charging
This would reduce the reliance on cables that pass through the skin.
7. Intelligent monitoring
The system must constantly monitor its own condition and the condition of the patient.
The next frontier – a fully autonomous bionic heart
The ideal future artificial heart could be fully implanted.
It would contain:
mechanical pump
internal engine
battery
wireless charging
sensors
intelligent controller
communication with external devices
Such a device could work without an external driver and without tubes passing through the skin.
This would represent a qualitative leap in the development of artificial organs.
The artificial heart and the future of medicine
The story of the artificial heart shows very well how biomedical engineering is developing.
The original goal was relatively simple:
to maintain circulation long enough for the patient to receive a transplant.
The next goal is:
to create a device that can work outside the hospital.
The following:
to remove the external apparatus.
And the ultimate goal:
to create a fully implantable artificial heart that can replace the natural organ permanently.
As of 2026, humanity is between the third and fourth stages.
Conclusion
The artificial heart is no longer just science fiction.
Modern total artificial hearts can actually replace the heart’s pumping function in certain patients and sustain life until transplant.
SynCardia was the first FDA-approved total artificial heart system and continues to be used clinically as a bridge to transplantation. (FDA Access Data)
BiVACOR represents a new generation of technology with a magnetic levitating rotor and electromechanical pumping. The first human implantation took place in 2024, and in 2025, a patient in Australia lived 105 days with the device outside the hospital before receiving a transplant. (Monash University)
Aeson represents another approach, a more biomimetic artificial heart that continues to be clinically tested and followed up in Europe. (ICHGCP)
At the same time, Emperor’s development aims to eliminate the external pneumatic driver and create the basis for a fully implantable artificial heart. As of 2026, this system is still in the preclinical stage. (JACC)
Therefore, the scientific picture to 2026 is as follows:
We can now replace the mechanical pumping function of the human heart.
But we cannot yet replace the human heart with an artificial organ that can reliably work autonomously and continuously throughout life.
The next big step will be the creation of:
fully implantable + wireless charging + self-regulating + long-lasting artificial heart.
This would be more than just a medical prosthesis.
It would be a full bionic replacement for one of the most important human organs.
In summary, we can say that we have artificial hearts that can support the patient for months and even allow discharge from the hospital, but we do not have an approved fully implantable artificial heart for lifelong permanent replacement of the natural organ.
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