Mechanical circulatory support: new advances, new pumps, new ideas

Mechanical circulatory support (MCS) is a viable therapy for severe end-stage heart disease. Most obstacles to long-term MCS therapy have been overcome, and a number of clinical trials, including the recent REMATCH trial, have shown a clear benefit in terms of survival and improved quality of life. MCS should therefore no longer be considered as simply a temporary bridge to other therapies, but also a destination therapy whose potential should continue to expand through the development and use of newer, more innovative devices such as continuous flow pumps, next-generation centrifugal pumps, and total artificial hearts. The homebound heart failure patient and the patient facing imminent death from massive myocardial infarction receive little statistical benefit from current therapies, and the new and evolving MCS technologies offer the potential for effective therapy to these desperately ill patients.