End-stage heart failure occurs when the myocardium can no longer maintain sufficient cardiac output to meet the metabolic demands of the body. This condition is characterized by a significant reduction in ejection fraction, leading to systemic congestion, pulmonary edema, and multi-organ failure. When medical management and conventional surgeries (such as valve repair) are no longer effective, mechanical circulatory support becomes necessary. The primary goal of an artificial heart is to restore hemodynamics, thereby allowing vital organs like the kidneys and liver to recover from chronic hypoperfusion.

The decision to transition a patient to a mechanical heart depends on whether the failure is univentricular or biventricular. In many cases, supporting only the left ventricle is sufficient; however, when both the right and left sides of the heart are compromised, a total artificial heart (TAH) is indicated. For technical specifications and clinical data on the devices used to manage these conditions, researchers often consult the Artificial Heart Market documentation for an overview of current regulatory-approved systems. This stage of intervention serves either as a temporary bridge to a biological transplant or as a permanent "destination therapy."

Beyond immediate survival, mechanical intervention aims to reverse the debilitating symptoms of heart failure, such as dyspnea and extreme fatigue. By providing a consistent flow of oxygenated blood, these devices enable patients to regain physical strength and improve their quality of life. The physiological impact is profound, as the restoration of normal blood pressure levels can halt the progressive damage caused by the body's compensatory mechanisms, such as the overactivation of the renin-angiotensin-aldosterone system (RAAS).