Another reason not to fret about this issue too much is that every possible answer involves just assuming that Starfleet transporters have godlike powers to do things like instantly reconnect artificial organs with smaller real organs or shrink down the fist-sized heart on the fly.
Maybe we should give the transporter such credit—after all, the system would functionally allow for Starfleet officers to stay immortal if used in a slightly different way. So if the system that allows humanity to perpetually cheat death as needed is also able to magically handle Picard’s artificial heart, we’ll just have to accept that.
If nothing else, it’s a safe bet you’ll never view “Rascals” again without asking yourself these questions. It’s tough for Next Generation fans to see young Picard and not think that the unknown status of his artificial heart makes for one big plot hole. But the episode itself is so charming that we’ll do our best young Picard impression and dub this glaring issue “our number one plot hole.”
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