At Work in the Classroom: the Carmat Total Artificial Heart Case Study
The Aeson Total Artificial Heart was envisioned by the French biomedical company, Carmat, as an opportunity to provide heart failure patients with a permanent alternative to the lengthy and unpredictable process of matching with a donor and receiving a heart transplant.
As of 2020, this device is commercially available in the European Union as a “bridge to transplant,” meaning that it is a temporary treatment for heart failure until a transplant from a donor can be matched.
Notably, the Aeson device is shown to fit 86% of male patients – but only 14% of female patients.
The “Engineering Heartbeats” Carmat Total Artificial Heart Case Study was developed by Sara Hoffman, Assistant Director of Educational Content and Research Integration at the Center for Socially Engaged Engineering & Design, to examine the trade-offs that resulted from this device’s development, design, and testing.
Ultimately, this resource provides an opportunity for students to practice critical thinking in a complex design scenario.
Why teach the Carmat Total Artificial Heart Case Study?
To demonstrate the impact of specific design and testing decisions
This case study illustrates how decisions made regarding design and how to test a design can impact access and long-term durability.
Students will consider how certain choices made in pursuit of Carmat’s vision for a self-contained mechanical device directly impacted the accessibility, marketability, and feasibility of the design. By prioritizing the device’s capacity to mimic a human heart, the Aeson device was ultimately too large to fit inside the chest cavity of smaller bodies, including many women and children.
In addition, students will reflect on Carmat’s trial strategies and discuss the trade-offs that resulted from conducting clinical trials in regions where patients already have greater access to transplant and device options.
To prompt critical thinking in a real-life design scenario
The Carmat Total Artificial Heart Case Study reflects the complex realities of engineering – especially medical device design.
By engaging with an open-ended and carefully scaffolded resource, students are prompted to consider potential outcomes for the future and ask the critical questions that they can apply in their own careers as designers – especially in evaluating social implications of very technical decisions.
What topics/concepts are covered in this content?
Designing for Human Variability
The Aeson Artificial Heart is a single device, but heart failure affects a variety of patients with varying chest cavity sizes.
This case study asks students to consider how Carmat accounted for the variability of heart failure, and how they could have made alternative decisions.
Not only will students explore the design decisions of Carmat, but they will also examine the alternate paths of Carmat’s competitors, SynCardia and BiVACOR.
Sara Hoffman, who developed this case study, articulates the decision to explore these differing design paths, saying, “We want students to recognize that there’s a variety of ways to approach designing for variability. It’s important for students to contextualize and see that, within all of these constraints, people have tried other approaches.”
Identifying trade-offs
The Aeson device was designed primarily for larger adults in Europe and North America – a market that already has the greatest access to transplants.
“Larger adults, including many men, are an important group of users,” explains Hoffman. “But we just want students to be aware that they’re not the only patients who need this technology. Smaller adults, especially women, are also really impacted by heart failure in a significant way. We want students to at least think about the possibilities for which patient populations could be prioritized before they are limited by the story of what Carmat did.”
Acknowledging constraints
Constraints are inherent in design scenarios – what you’re able to do, where, with whom, and how effectively. In this case study, students will identify and analyze the constraints that informed Carmat’s process.
“It’s helpful for students to understand real-world constraints, and to avoid an idealistic look back on what they [Carmat] should have done,” explains Sara Hoffman. “A lot of the decisions made sense in terms of some of the constraints they faced.”
Components of the Aeson Total Artifical Heart in a cross-section
Opportunities for Adaptation
The following are concepts that exist already in the Carmat Total Artificial Heart Case Study, but could be drawn out to serve a particular classroom:
- Specific design elements of the Aeson artificial heart (examples: electro-hydraulic pump design, pulsatile flow, biocompatible materials, autoregulating technology, and embedded electronics)
- Trial design
- Engineering leadership
- The influence of business on engineering
What courses have featured the Carmat Total Artificial Heart Case Study?
Instructors have used this resource in courses such as:
- Introduction to Engineering
- Medical device design
- Industrial & Operations Engineering
- Healthcare Design
- Mechanical Engineering Senior Capstone
- BioMedical Engineering Senior Capstone
Note: There are no prerequisite skills/knowledge required for students before engaging with this material.
How do I download this case for use in my classroom?
If the learning goals and topics of the Carmat Total Artificial Heart Case Study support your objectives, visit C-SED’s Educator Downloads page to access its content.