Abstract
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.
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References
A pioneer in artificial organs, Heart Trans., 1: 158, 1982.
Kolff WJ, Akutsu T, Dreyer B, et al: Artificial heart inside the chest and the use of polyurethane for making valves and aortas, Trans. Am. Soc. Artif. Intern. Organs, 7: 198, 1959.
The working group on mechanical circulatory support, National Heart, Lung and flood Institute. Artificial heart and assist devices: Directions, needs, costs, societal and ethical issues, U.S. Dept. of Health and Human Services, No. (NIH) 85–2723, Public Health Service, 1985.
Oakes TE, Pae WE, Miller CA, Pierce WS: Combined registry for the clinical use of mechanical ventricular assist pumps and the total artificial heart in conjunction with heart transplantation: Fifth official report-1990, J. Heart and Lung Trans., 10: 621, 1991.
Hill JD: Bridging to transplantation, Ann. Thorac. Surg., 47: 167, 1989.
Ott RA, Mills TC, Eugene J, Gazzania AB: Clinical choices for circulatory assist devices, Trans. Am. Soc. Artif. Intern. Organs, 36: 792, 1990.
Pennington DG, Swartz MT: Management: By circulatory assist devices, Cardiology Clinics, 7: 195, 1989.
Pennington DG, Joyce LD, Pae WE, Bucholder JA: Patient selection (proceedings from Circulation Support 1988, Topical Meeting of the Society of Thoracic Surgeons), Ann Thorac. Surg., 47: 77, 1989.
Pennington DG, Termuhlen DF: Mechanical circulatory support: Device selection, Cardiac Surgery: State of the art reviews, 3: 407, 1989.
Emery RW, Joyce LD: Directions in cardiac assistance, J. Cardiac Surg., 6: 400, 1991.
Ott RA, Mills TC, Eugene J: Current concepts in the use of ventricular assist devices, Cardiac Surgery: State of the art reviews, 3: 521, 1989.
Pae WE, Pierce WS: Intra-aortic balloon counter-pulsation, ventricular assist pumping and the artificial heart, In: Glenn’s Thoracic and Cardiovascular Surgery (Ed., Bane AE ), Appleton and Lange, Norwalk, CT, 1990.
DeVries WC, Anderson JL, Joyce LD, et al: Clinical use of the total artificial heart, New Engl. J. Med., 310: 274, 1984.
DeVries WC: The permanent artificial heart; four case reports, JAMA, 259: 849, 1988.
Pierce WS: Permanent heart substitution: better solutions lie ahead, JAMA, 259: 891, 1988.
Joyce LD, Johnson ICE, Cabrol C, Griffith BP, et al: Trans. Am. Soc. Artif. Intern. Organs, 34: 703, 1988.
Dennis C, Spring DS, Nelson GE, et al: Development of a pump oxygenator to replace the heart and lungs; an apparatus applicable to human patients, and application as one case, Ann. Surg., 709: 721, 1951.
Stuckey JH, Newman MM, Dennis C, et al: The use of the heart lung machine in selected cases of acute myocardial infarction, Surg. Forum, 8: 342, 1957.
Gibbon JH, Jr.: Application of a mechanical heart and lung apparatus to cardiac surgery, Minn. Med., 37: 171, 1954.
Spencer FC, Eisman B, Trinkle ICJ, Rossi NP: Assisted circulation for cardiac failure following intracardiac surgery with cardiopulmonary bypass, J. Thorac. and Cardiovasc. Surg., 49: 56, 1965.
Moulopoulas SD, Topaz S, Kolff WJ: Diastolic balloon pumping (with carbon dioxide) in the aorta: Mechanical assistance to the failing circulation, Am. Heart J., 63: 669, 1962.
Kantrowitz A, Tionneland S, Krakauer JS, et al: Mechanical intra-aortic cardiac assistance in cardiogenic shock: Hemodynamic effects, Arch. Surg., 97: 1000, 1968.
Sanfilippo PM, Baker NH, Ewy HG, Moore PJ, et al: Experience with intra-aortic balloon counter-pulsation, Ann. Thorac. Surg., 41: 36, 1986.
Weintraub RM, Thurer RL: The intra-aortic balloon pump-a ten year experience, Heart Transplantation, 3: 8, 1983.
Reemstsma K, Drusin R, Edie R, et al: Cardiac transplantation for patients requiring mechanical circulatory support, N. Engl. J. Med., 298: 670, 1978.
Bregman D, Casarella WJ: Percutaneous intra-aortic balloon pumping: Initial clinical experiences, Ann. Thorac. Surg., 29: 153, 1980.
Subramanian VA, Goldstein JE, Sos TA, et al: Preliminary clinical experience with percutaneous intra-aortic balloon pumping, Circulation, 62 (supplement I:I), 1980.
Miller DC, Moreno-Cabral RJ, Stinson EB, et al: Pulmonary artery balloon counterpulsation for acute right ventricular failure, J. Thorac. Cardiovasc. Surg., 80: 760, 1980.
Symbas PN, McKeown PP, Santora AH, Vlasis SE, Hatcher CR: Pulmonary artery balloon counterpulsation for treatment of intraoperative right ventricular failure, Ann. Thorac. Surg., 39: 437, 1985.
Moran JM, Opravil M, Gorman AI, et al: Pulmonary artery balloon counterpulsation for right ventricular failure II. Clinical experience, Ann. Thorac. Surg., 38: 254, 1984.
Spence PA, Weisel RD, Easdown J, et al: Pulmonary artery balloon counterpulsation in the management of right heart failure during left heart bypass, J. Thorac. Cardiovasc. Surg., 38: 242, 1984.
Spence PA, Weisel D, Easdown J, et al: The hemodynamic effects and mechanism of action of pulmonary artery balloon counterpulsation in the treatment of right ventricular failure, Ann. Thorac. Surg., 39: 437, 1984.
Wampler RK, Moise JC, Frazier OH, Olsen DP: In vivo evaluation of a peripheral vascular access axial flow blood pump, Trans. Am. Soc. Artif. Intern. Organs, 34: 450, 1988.
Wampler RK, Frazier OH, Lansing AM, Smalling RW, et al: Treatment of cardiogenic shock with the hemopump left ventricular assist device, Ann Thorac. Surg., 52: 506, 1991.
Duncan JM, Frazier OH, Radovancevic B, Velebit V: Implantation techniques for the hemopump, Ann. Thorac. Surg., 48: 733, 1989.
Golding LAR, Stewart RW, Sinhowich M, et al: Non-pulsatile ventricular assist bridging to transplantation, Trans. Am. Soc. Artif. Organs, 34: 476, 1988.
Zumbro GL, Shearer G, Kitchens WR, Galloway RF: Mechanical assistance for biventricular failure following coronary bypass operation and heart transplantation, Heart Transplantation, 4: 348, 1985.
Karl TR, Sano S, Horton S, Mee RBB: Centrifugal pump left heart assist in pediatric cardiac operations, J. Thorac. Cardiovasc. Surg., 102: 624, 1991.
Gray LA, Ganzel BL, Mavroudis M, Slater AD: The Pierce-Donachy ventricular assist device as a bridge to cardiac transplantation, Ann. Thorac. Surg., 48: 222, 1989.
Farrar DJ, Lawson JH, Letwak P, Cedarwall G: Thoratec VAD system as a bridge to transplantation, J. Heart Transplant. 9: 415, 1990.
Farrar DJ, Hill JD, Gray LA, Pennington DJ, et al: Heterotopic prosthetic ventricles as a bridge to cardiac transplantation, N. Engl. J. Med., 318: 333, 1988.
Pennington DG, Samuels LD, Williams G, Palmer D, et al: Experience with the Pierce-Donachy ventricular assist device in post-cardiotomy patients with cardiogenic shock, World J. Surg., 9: 37, 1985.
Pierce WS, Parr GVS, Myers JL, et al: Ventricular assist pumping in patients with cardiogenic shock after cardiac operations, N. Engl. J. Med., 305: 1606, 1981.
Lawson JH, Cederwall G: Clinical experience with the Thoratec ventricular assist device, In: Assisted Circulation 3 (Ed., Unger F ), Springer-Verlag, Berlin, 1989.
Kanter KR, McBride LR, Pennington DG, Swartz MT, et al: Bridging to cardiac transplantation with pulsatile ventricular assist devices, Ann Thorac Surg., 46: 134, 1988.
Termuhlen DF, Swartz MT, Pennington DG, et al: Thromboembolic complications with the Pierce-Donachy ventricular assist device, Trans. Am. Soc. Artif. Intern. Organ., 35: 616–618, 1989.
Champsaur G, Ninet J, Vigneror M, Cochet P, Neidedur J, Boissonnat P: The use of the ABIOMed BVS System 5000 as a bridge to cardiac transplantation, J. Thorac. Cardiovasc. Surg., 100: 122, 1990.
McGee MG, Parnis SM, Nakatani T, Myers T, et al: Extended clinical support with an implantable left ventricular assist device, Trans. Am. Soc. Artif. Intern. Organs, 35: 614, 1989.
Goldsmith MF: Portable heart pump recipient recovering well; evaluation begins of role for this technology, JAMA, 266: 2666, 1991.
Dasse K: Personal communication, 10/29/1991.
Starnes VA, Oyer PE, Portner PM, et al: Isolated left ventricular assist as a bridge to cardiac transplantation, J. Thorac. Cardiovasc. Surg., 96: 62, 1988.
Kormos RL, Borovetz HS, Grasior T, Antaki JF, et al: Experience with univentricular support in mortally ill cardiac transplant candidates, Ann. Thorac. Surg., 49: 261, 1990.
McCarthy PM, Portner PM, Tobler HS, Starnes VA, et al: Clinical experience with Novacor ventricular assist system, J. Thorac. Cardiovasc. Surg., 102: 578, 1991.
Portner DM, Oyer PE, Pennington DG, Baumgartner WA, Griffith BP, et al: Implantable electrical left ventricular assist system; bridge to transplantation and the future, Ann. Thorac. Surg., 47: 142, 1989.
Termuhlen DF, Swartz MT, Pennington DG, et al: Predictors for weaning from ventricular assist devices (VADs), Trans. Am. Soc. Artif. Intern. Organs, 33: 683, 1987.
Farrar DJ, Chow E, Compton PG, Foppiano L, Woodard J, Hill JD: Effectors of acute right ventricular ischemia on ventricular interactions during prosthetic left ventricular support, J. Thorac. Cardiovasc. Surg., 102: 588–595, 1991.
Fukuda S, Takano H, Tanenaka Y, et al: Chronic effect of left ventricular assist pumping on right ventricular function, Trans. Am. Soc. Artif. Intern. Organs, 34: 712, 1988.
Ramasamy N, Chen H, Miller PJ, Jassawalla JS, et al: Bioprosthetic value calcification and pseudo-neointimal proliferation in bovine and ovine model, Trans. Am. Soc. Artif. Organs, 34: 696, 1988.
Altieri FD, Watson JT: Implantable ventricular assist systems, Artificial Organs, 11: 237, 1987.
Olsen DB, Burnes GL: Total artificial heart: The Salt Lake perspective, In: Cardiovascular Science and Technology: Basic and Applied II, Oxymoron Press, Boston, 1990.
McKeown PP, Kovacs SG, Reynolds DG, Wassell JA, et al: Magnetically circulated LVAD: Initial animal test results, In: Cardiovascular Science and Technology: Basic and Applied II (Ed., Norman JC ), Louisville, KY, USA, 1990.
McKeown PP, Kovacs SG, Ondrovic L, et al: Acute animal studies using the Kovacs/McKeown MALVAD Electro-magnetic Heart Pump, AAMI Proceedings, Dec. 2–4, Washington, DC (abstract ), 1991.
Kovacs SG, Reynolds DG, McKeown PP, et al: A magnetically actuated left ventricular assist device (MALVAD), Trans. Am. Soc. Artif. Intern. Organs, in press, 1991.
Koroly MV, Ida N, Roemer LF: An electromagnetic actuator using recently developed rate earth permanent magnets, In: Recent Advances in Cardiovascular Surgery (Ed., Reichart B ), R. S. Schultz, Seehang, Germany, 1989.
Miller PJ, Green GF, Chen H, et al: In vivo evaluation of a compact, implantable left ventricular assist system (LVAS), Trans. Am. Soc. Artif. Intern. Organs, 29: 551, 1983.
Portner PM, Oyer PE, Jassawalla JS, et al: A totally implantable ventricular assist system for end-stage heart disease, In: Assisted Circulation 2 (Ed., Unger F ), Springer-Verlag, Berlin, 1984.
Portner PM, Oyer PE, Jassawalla, Miller PJ, et al: An implantable permanent left ventricular assist system for man, Trans. Am. Soc. Artif. Intern. Organs, 24: 98, 1978.
Weiss WJ, Rosenberg G, Snyder AJ, Cleary TJ, et al: Permanent circulatory support systems at Penn State University, Intern Electronic and Elec. Sciences Transaction in Biomedical Engineering, 37: 138, 1990.
Igo SR, Hibbs CW, Fuqua JM, et al: Theoretic design considerations and physiologic performance criteria for an improved intracorporeal (abdominal electrically-actuated long-term left ventricular assist device (E-type ALVAD) or partial artificial heart, Cardiovasc. Dis. (Bull. THI), 5: 172, 1978.
O’Bannon W, Donachy HH, Brighton JA, et al: A comparison of three ventricles used for left ventricular bypass in the calf, Trans. Amer. Soc. Artif. Int. Organs, 22: 450, 1976.
Fuqua JM, Igo SR, Edmonds CH, Hibbs CW, Normal JC: Evaluations of left ventricular apex orientation in patients with congestive cardiomyopathy: Implications for long-term left ventricular assist devices, Clin. Res., 26: 646A, 1978.
Baldwin JT, Tarbell JM, Deutsch S, Geselowitz DB: Mean flow velocity patterns within a ventricular assist device, Trans. Am. Soc. Artif. Intern. Organs, 35: 429, 1989.
Portner PM, Green GF, Ramasamy N: The blood interface at artificial surfaces within a left ventricular assist system, Ann. NY Acad. Science, 471–499, 1983.
Farrar DJ, Litwak P, Lawson JH, et al: In vivo evaluation of a new thromboresistance polyurethane for artificial heart pump, J. Thorac. Cardiovasc. Surg., 95: 191, 1988.
Dasse KA, Chapman SD, Sherman CN, Devine All, Frazier OH: Clinical experience with textured blood contacting surfaces in ventricular assist devices, Trans. Am. Soc. Artif. Intern. Organs, 33: 418, 1987.
Hammond GL, Geha AS, Kopf GS, Hashim SW: Biological versus mechanical valves, J. Thorac. Cardiovasc. Surg., 93: 182, 1987.
Cortina JM, Martinell J, Artiz V, et al: Comparative clinical results with Omniscience (STM1), Medtronic Hall and Bjork-Shiley convexo-concave (70 degrees) prostheses in mitral valve replacement, J. Thorac. Cardiovasc. Surg., 91: 174, 1986.
Schoen FJ: The future of bioprosthetic valves, Trans. Am. Soc. Artif. Intern. Organs, 34: 1040, 1988.
Jones M, Eibo EE, Hilbert SL, Ferrans VJ, Clark RE: The effects of anticalcification treatments on bioprosthetic heart valves implanted in sheep, Trans. Am. soc. Artif. Intern. Organs, 34: 1027, 1988.
Garcia Paez JM, San Martin AC, Garcia Sestafe JV, et al: Is cutting stress responsible for limited durability of heart valve bioprostheses ? J. Thorac. Cardiovasc. Surg., 100: 580, 1990.
Clark RE: The future of bioprosthetic valves, Trans. Am. soc. Artif. Intern. Organs, 34: 1021, 1988.
Gabbay S, Welch H: Reducing the variability in durability of heart valve prostheses, Trans. Am. soc. Artif. Intern. Organs, 34: 1022, 1988.
Clark RE, Swanson WM, Kardow JL, et al: Durability of prosthetic heart valves, Ann Thorac. Surg., 26: 323, 1978.
Knott E, Reul H, Knoch M, et al: In vitro comparison of aortic heart valve prostheses, J. Thorac. Cardiovasc. Surg., 96: 952, 1988.
Kovacs SG, McKeown PP: Prosthetic valve selection for a pulsatable LVAD, J. Clin. Engineering, Nov/Dec, in press, 1991.
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McKeown, P.P., Kovacs, S.G. (1992). Mechanical Support for the Failing Heart. In: Hwang, N.H.C., Turitto, V.T., Yen, M.R.T. (eds) Advances in Cardiovascular Engineering. NATO ASI Series, vol 235. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-4421-7_20
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DOI: https://doi.org/10.1007/978-1-4757-4421-7_20
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