There's a little bit of MacGyver in all of us so even if it's unlikely to come up in our day-to-day lives, it would be nice to know how to do an artificial heart transplant in case it becomes really, really necessary, like you need to save a third world dictator or his second-in-command will launch a nuclear bomb.

The Journal of Visual Experiments is here to help. They have made it possible to watch the implantation of the SynCardia temporary Total Artificial Heart as you read their journal article. The paper and video both describe the case of a 60-year-old male with hypertrophic cardiomyopathy. Both detail the implantation surgery. They also discuss perioperative complications, postoperative care and selection of good candidates for the procedure.

Originally used as a permanent replacement heart, the SynCardia Total Artificial Heart is currently approved as a bridge to transplant for people suffering from end-stage biventricular heart failure in which both ventricles can no longer pump enough blood for a person to survive.

Pretreating the arterial outflow grafts. The aortic and pulmonary artery grafts are presealed with Coseal Surgical Sealant, a synthetic hydrogel used as an adjunctive sealant for vascular grafts. Previously the grafts were preclotted with patient's own blood prior to heparinization. Credit: DOI: doi:10.3791/50377

"Patients often present with cardiogenic shock and multi-system organ dysfunction," according to the paper by Drs. Daniel G. Tang, Keyur B. Shah, Michael L. Hess and Vigneshwar B. Kasirajan. "Excision of both ventricles and orthotopic replacement with the [SynCardia Total Artificial Heart] is an effective…therapy for rapid restoration of blood flow and resuscitation."

Heart failure patients who are extremely sick can get a second chance at life with the SynCardia Total Artificial Heart. It is the only approved device that eliminates the source of end-stage biventricular (both sides) heart failure in which the native heart ventricles can no longer pump enough blood for the patient to survive.

"The main advantage of the Total Artificial Heart over left ventricle assist devices [LVADs] is the [SynCardia Total Artificial Heart] allows for high-flow biventricular support," Tang, VCU assistant professor of cardiothoracic surgery, says in the video, "as well as the ability to treat a wide range of complex cardiac pathology that may not be ideally treated with isolated [LVAD] support."

Citation: Tang, D. G., Shah, K. B., Hess, M. L., Kasirajan, V. Implantation of the Syncardia Total Artificial Heart. J. Vis. Exp. (89), e50377, doi:10.3791/50377 (2014).