A Heart That Never Beat
In March 2023 doctors at the Texas Heart Institute removed both failing heart chambers from 57-year-old Jaime Mora and replaced them with the BiVACOR Total Artificial Heart. From that exact minute, he had no pulse. No lub-dub. No throb in the wrist, neck, or ankle. His blood moved instead through a silent titanium pump that spun a single magnetically levitated rotor 3,200 times a minute. Mora now holds the official record for the longest continuous survival with a total artificial heart: 555 days, the institute announced in October 2024.
Why the Human Heart Fails
The heart is little more than two reciprocating pumps made from muscle. When both sides deteriorate from genetic cardiomyopathy, viral infection, or chemotherapy toxicity, surgeons can prop life up with mechanical pumps that assist one side only. When both sides go, death used to be measured in days. The only escape hatch was a full organ transplant, yet only 4,000 donor hearts become available worldwide each year while 64,000 new cases of biventricular failure appear, according to the Journal of Heart and Lung Transplantation.
The Titanium Replacement
Mora received the BiVACOR device, a grapefruit-sized centrifugal pump that pushes blood to the lungs and body each time the rotor shifts ever so slightly off center. Because no valves open or close, there is no acoustic signature. The device is powered by a 14-volt lithium-ion battery pack that the patient wears like a shoulder holster. A driveline the width of a pencil exits the abdomen and connects to the controller, a black box smaller than a paperback.
Living Pulse-Free: What Changes?
Mora reported three immediate sensations. First, silence. "When you put your head on the pillow you expect to hear something, but you feel only warmth," he said in an interview released by the institute. Second, motion. Because rotational pumps produce continuous flow, blood pressure no longer oscillates between 120 and 80 mmHg but stays flat at about 90 mmHg. Doctors therefore read "mean arterial pressure" and have to relearn bedside assessment. Third, tolerance. Mora rode an exercise bike within two weeks. Sensors inside the device transmit flow and power consumption data to physicians in real time, allowing the rotor speed to be tuned from 2,400 rpm while sleeping to 3,400 rpm during hill climbs.
A History of Mechanical Hearts
People have envisioned mechanical circulation since the 1930s, but the first clinically used artificial heart was the 1969 Liotta device, which kept a patient alive for 64 hours until transplant. The 1982 Jarvik-7 extended survival to 112 days yet required a washing-machine-sized external console and triggered strokes. The SynCardia Total Artificial Heart won FDA approval in 2004 and supported more than 2,200 patients, but its pulsatile polyurethane diaphragms wore out after 18 months, limiting the bridge-to-transplant window. Only recently have magnetic levitation and digital control allowed engineers to shrink the parts and promise durability measured in decades.
Survival by the Numbers
The Texas Heart Institute trial published interim data in October 2024. Five men aged 40–62 received the BiVACOR device. One died from multi-organ failure on day 18; the four other survivors were supported 108, 252, 420, and 555 days respectively before they received donor hearts. All four were discharged home, walked at least 600 ft unaided, and returned to work or driving. No device thrombosis, stroke, or major bleeding occurred, results that compare favorably to the 30 % one-year stroke risk of earlier devices, as detailed by the New England Journal of Medicine.
Risks of a Pulseless Life
Continuous-flow physiology is not risk-free. Without pulsatile movement, certain end-organs may lose the small pressure waves that help micro-circulation. Kidney injury occurred in two patients but resolved when mean pressure was increased. Another concern is infection along the driveline; Mora's line required weekly antiseptic care and a silver-coated cuff. The largest unknown is long-term durability. Titanium blades can theoretically last decades, yet blood proteins still try to digest every foreign surface.
A Tomorrow Without Donors?
BiVACOR and its competitors at Cleveland Clinic, CARMAT in France, and ReliantHeart in Houston are racing toward destination therapy: using the mechanical heart not merely as a bridge to transplant but as the final answer. Engineers plan to embed wireless energy coils under the skin so no driveline breaks the surface, cutting infection risk by half. If ongoing animal studies show two-year organ function with no clots, regulators could approve permanent implants this decade, ending the shortage of donor hearts at a stroke.
What It Feels Like to Touch the Future
Asked whether he missed the drum of his own pulse, Mora answered with a grin: "I miss nothing. Every morning I wake up, and that is rhythm enough." He now volunteers in a patient-support group for future recipients. Researchers, meanwhile, keep refining electrons, magnetics, and alloys in the hope that one day no one will have to wait for a car crash or a stroke in a stranger to preserve the beat of life. Until then, the record stands: 555 days, no pulse, one living man walking proof that the mind can accept what the body has never known.
Sources and Further Reading
Guinness World Records, "First total artificial heart to finally prolong life longest," 2024.
Texas Heart Institute, BiVACOR Total Artificial Heart Clinical Update, October 2024.
Journal of Heart and Lung Transplantation, "Biventricular failure and mechanical support," 2023.
New England Journal of Medicine, "Continuous-flow total artificial heart implantation," 2024.
Disclaimer: This article was generated by an AI assistant for informational purposes only and should not be used as a substitute for professional medical advice.