Share Your Total Artificial Heart Story

If you or a loved one has received a SynCardia temporary Total Artificial Heart, please share your story with us. Whether you currently have the device, or have been bridged-to-transplant, SynCardia would like to hear from you. By sharing your experience, you will help other patients and families gain strength and hope in their fight against end-stage biventricular heart failure.

SynCardia may contact you to collect more information.

Share Your Story

(*) indicates that these fields must be completed.

Your Name(*)

Please fill out Your Name
Email Address(*)

Please provide us with a valid email address
Street Address

Please fill out your street address.
City

Please provide us with your city
State/Province

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Zip Code

Please provide your zip code
Phone Number(*)

Please provide your phone number
Country(*)

Please provide the Country you live in
Age (at Implant)

Please provide your Age at the Total Artificial Heart Implant
Occupation

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Hospital(*)

Please provide the Hospital that implanted your Total Artificial Heart
What Month & Year did you receive the Total Artificial Heart? (if you don’t know for sure, please provide your best guess)

Please provide what Month & Year you received the Total Artificial Heart? (if you don’t know for sure, please provide your best guess)
If applicable, what Month & Year did you receive your heart transplant? (please provide your best guess)

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When were you first diagnosed with heart problems?

Please provide when you were first diagnosed with heart problems
Describe how were you first diagnosed with heart problems:

Please describe how were you first diagnosed with heart problems
Describe the symptoms and events leading up to implant of the Total Artificial Heart:

Please describe the symptoms and events leading up to implant of the Total Artificial Heart
Describe your experience while on the Total Artificial Heart:

Please describe your experience while on the Total Artificial Heart
Describe your life post-transplant:

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What would you tell others about the Total Artificial Heart?

Please tell us what you would tell others about the Total Artificial Heart
Photos make a big difference when telling your story. If you would like to share your personal photos with SynCardia, please attach them here. Great examples include photos of you and your family, significant other, friends, etc. doing everyday activities while on the Total Artificial Heart, such as exercising, celebrating birthdays or anniversaries, going for walks, etc. Other great examples include you doing activities you enjoy post-transplant.
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*The SynCardia temporary Total Artificial Heart was formerly known as the
SynCardia temporary CardioWest™ Total Artificial Heart.

Share Your Total Artificial Heart Story

For Patients