Progress and future perspectives in mechanical circulatory support

Progress in several types of artificial organs in the cardiovascular field has significantly contributed to advancements in cardiac surgery. Due to the progress of high technology in fields other than medicine, both cardiac surgery and artificial organs have shown rapid and remarkable advances. In recent years, several types of blood pumps have been developed that are widely used not only as the main pump of cardiopulmonary bypass but also for circulatory support of postcardiotomy cardiogenic shock. In this article, the progress and current status of percutaneous cardiopulmonary support systems and ventricular assist devices (VADs) are described. In addition, new centrifugal and axial pumps, which are compact and implantable clinical use devices, are introduced. I believe that by making developments toward the clinical application of artificial hearts or VADs, not only in Japan but also in cooperation with colleagues at various institutions throughout the world, we will be able to make some contributions to the progress in the field of cardiac surgery. In the 20th century, medical research showed remarkable advances, mainly in medical electronics and pathophysiology. However, in the next century, we have to focus on other research fields, namely artificial organs and gene technology.