A Case Study of the Nursing Challenges in Caring for a Patient with a Totally Artificial Heart.

Heart failure represents a growing global health burden, with mechanical circulatory support devices becoming essential for managing end-stage disease. The total artificial heart (TAH) offers a lifesaving option for patients with biventricular failure when transplantation is not immediately available. We report Israel's first TAH implantation in a 63-year-old man with end-stage biventricular heart failure secondary to dilated cardiomyopathy. Following progressive clinical deterioration despite maximal medical therapy, the patient underwent successful implantation of the Carmat bioprosthetic TAH as a bridge to transplantation. The procedure, performed in May 2025, represented the 115th such implantation worldwide. This pioneering case presented unprecedented nursing challenges requiring the development of care protocols without existing national guidelines. Key challenges included rapid acquisition of complex device technology, creation of documentation systems and workflows, continuous haemodynamic monitoring and alarm interpretation, management of postoperative complications including thrombotic obstruction, provision of psychosocial support for patient and family adaptation, and coordination of multidisciplinary transitional care planning. This case demonstrates that successful high-technology cardiac support requires not only surgical expertise but also specialised nursing leadership in protocol development, rapid skill acquisition, interdisciplinary collaboration, and integration of technical care with psychosocial support. The experience establishes a framework for future TAH programmes in Israel and underscores the essential role of advanced nursing practice in pioneering cardiac technologies. Total artificial heart, mechanical circulatory support, nursing care, bridge to transplant, cardiac intensive care, case report.