Mechanical Support for the Failing Heart

For an increasing number of cardiac patients mechanical support devices have meant the difference between life and death. Mechanical support encompasses cardiopulmonary bypass, intra-aortic balloon pumping, ventricular assist devices including pulsatile and nonpulsatile systems, and the total artificial heart (TAH). Circulatory support can be considered temporary (pending recovery of the natural heart or transplantation) or permanent. While the early experience with the Jarvik-7 TAH was disappointing, the severe shortage of donor hearts is stimulating attempts to develop other permanent implantable support systems. The technical and engineering challenges to produce a successful permanent artificial heart are significant but provide an exciting field of research for what we believe is an achievable goal.