Artificial Heart in the Management of Heart Failure: Advances, Challenges, and Clinical Applications

Heart failure (HF) is a complex clinical syndrome characterized by symptoms such as dyspnea, edema, and fatigue, resulting from structural or functional abnormalities of the heart. Despite advances in clinical and surgical treatment, mortality remains high, especially in end-stage cases. In this context, artificial hearts have emerged as a promising therapeutic alternative. Since the first human implant in 1960, these devices have significantly evolved, incorporating intelligent sensors and biocompatible materials that enhance their functionality and safety. This study aimed to analyze the role of artificial hearts, with a focus on the Total Artificial Heart (TAH), as a therapeutic resource for advanced heart failure, highlighting their clinical benefits, limitations, and practical implications. The methodology consisted of an integrative literature review with a qualitative approach. The databases used were LILACS, MEDLINE/PubMed, and SciELO. Inclusion criteria involved publications from the last five years, with full texts and review methodologies. The selection process included title and abstract screening followed by full-text reading of eligible studies. In total, 12 articles were included in the analysis. The results demonstrated that TAH represents a viable alternative to cardiac transplantation, especially given the shortage of donors. Studies showed improved survival rates, acceptable postoperative adaptation, and effective hemodynamic control with next-generation devices. However, complication and mortality rates remain significant, making careful patient selection and multidisciplinary team preparation essential. TAH has been consolidated both as a bridge to transplantation and as destination therapy in specific cases. In conclusion, artificial hearts represent a significant advancement in the treatment of terminal heart failure, providing expanded therapeutic options and improving the quality of life for affected patients.