It has been a long, hard road, but Carmat has finally become a revenue-generating company. The first commercial implant of its Aeson artificial heart, CE marked in December as a means to keep a patient with end-stage heart failure alive until they can receive a transplant, has gone ahead in Naples, Italy. The device has an estimated price of €160,000 ($188,000), and Carmat expects around a dozen European medical centres, most of them in Germany, to be commercially active by the end of 2021. Thus, even if each centre only does a single implant the company’s revenues for this year could be well into the millions. Encouraging developments are occurring on the other side of the Atlantic, too: the US feasibility trial of Aeson kicked off last week, and ought to yield data in 2022. Carmat has little competition. Ventricular assist devices such as Abbott’s HeartMate are not powerful enough for patients who need a transplant. Only one other company, Syncardia, sells an artificial heart. It was bought out of bankruptcy by private equity group Versa Capital Management in 2016, and last reported the implanting of one of its devices in 2018.