That's an LVAD, though -- isn't that an entirely different beast than an artificial heart, with a different use case?

It's still typically a massive change in quality of life. The left ventricle is what feeds your entire body blood; the right ventricle only feeds the lungs. When the left ventricle fails, blood backs up and starts overflowing into the lung space in addition to the rest of your body slowly suffocating. It's exceptionally unpleasant.

The right ventricle is usually in much better shape so an LVAD can be almost like having a functioning transplant, except that there's a big wire going out of your chest/neck (which is a constant infection risk and can't really get wet) and you're now battery-powered.

Any kind of heart transplant comes with huge problems, even besides the immunosupressants etc. The nerves don't reconnect, so the heart doesn't respond to commands to speed up. It makes any kind of exertion difficult and unpleasant. Diet is critical, clots are a constant fear, etc. By the time you get a transplant you've usually spent a while with insufficient bloodflow, and your organs have been slowly dying.

It's nothing short of incredible that people can get 20+ years out of transplants. The deck is stacked against us hard.

Artificial heart is kind of a non-specific term. It covers anything from LVAD, LBAD and RVAD together, ECMO or biventrivular vad. So depends on what you’re specifically referring to but lvad is the most common of those.

Fair enough. I'm in no way experienced in the medical field. I would have told you I thought an artificial heart was a complete heart replacement, just like a full transplant but with a mechanical device instead. TIL.

LVAD goes for 5 years

More like 10 and more now, 5 years was the stuff we were making in the 90s and early 2000s.