BlueCross BlueShield of Tennessee Medical Policy Manual

Total Artificial Heart (TAH)


Total artificial heart (TAH) is a pulsatile biventricular device that is implanted in the thoracic cavity to temporarily replace both native cardiac ventricles and all cardiac valves. The mechanical circulation support device is intended to act as a bridge to heart transplantation and perform the pumping function of a natural heart for an individual who is eligible for cardiac transplantation and at risk of imminent death from biventricular failure.

Currently, the SynCardia temporary Total Artificial Heart, formerly known as the CardioWest Total Artificial Heart, is the only TAH available in the United States.  The device was originally approved for in-hospital use.  In 2014, the FDA approved the SynCardia Freedom portable driver for use in individuals who have been implanted with the TAH and are clinically stable.  The portable driver allows the individuals to be discharged from the hospital while waiting for a donor heart.  The total artificial heart is intended for individuals who are not candidates for LVADs or BiVADs.





American College of Cardiology Foundation/American Heart Association. (2013). 2013 ACCF/AHA guideline for the management of heart failure. Retrieved February 1, 2017 from

BlueCross BlueShield Association. Evidence Positioning System. (8:2018). Total artificial hearts and implantable ventricular assist devices (7.03.11). Retrieved January 2, 2019 from (84 articles and/or guidelines reviewed)

Centers for Medicare & Medicaid Services. NCD for artificial hearts and related devices (20.9). Retrieved February 1, 2017 from

International Society for Heart and Lung Transplantation. (2013). The 2013 international society for heart and lung transplantation guidelines for mechanical circulatory support: executive summary.The Journal of Heart and Lung Transplantation, 32 (2), 157-187.

Nguyen, A., Pozzi, M., Mastroianni, C., L├ęger, P., Loisance, D., Pavie, A., et al. (2015). Bridge to transplantation using paracorporeal biventricular assist devices or the syncardia temporary total artificial heart: is there a difference? Journal of Cardiovascular Surgery (Torino), 56 (3), 493-502. Abstract retrieved February 3, 2017 from PubMed database.

U. S. Food and Drug Administration. (2004, October). Center for Devices and Radiological health. Pre-market approval decisions for October 2004. Retrieved February 1, 2017 from

Winifred S. Hayes, Inc. Medical Technology Directory. (2015, May; last update May 2018). Total artificial heart, temporary or permanent, biventricular mechanical circulatory support device. Retrieved January 2, 2019 from (79articles and/or guidelines reviewed)




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