Implantation Technique for the Aeson Total Artificial Heart

The autoregulated, pulsatile Aeson total artificial heart (Carmat SA, Vélizy Villacoublay, France) is a single-unit biventricular device. The central body comprises the two blood pumping ventricles and separate technical compartments which house two electrohydraulic pumps and control electronics which employ an algorithm informed by pressure sensors and volume detection transducers in each ventricle. The prosthesis is connected by an 8 mm driveline, which exits the skin in the lower right quadrant, to an external routing module and a controller powered by batteries. Since the first implantation took place in 2013, more than 40 patients have been successfully implanted during clinical studies, and commercially after the Aeson obtained its CE mark in 2020, as a bridge to transplant device. The size of the device and the lack of adhesions around the device body have been shown to facilitate relatively easy explantation and subsequent transplantation. With the growing experience, the implant procedure has evolved from experimental to a well-established routine procedure. The purpose of this article is to provide a guide for potential implanters in order to ensure that the advanced design benefits of the Aeson TAH are realized by incorporating optimal surgical techniques.