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Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
Total artificial hearts: past, present, and future
William E Cohn1, Daniel L Timms1, O H Frazier1
1Cardiovascular Surgical Research Laboratory and the Center for Cardiac Support, Texas Heart Institute, MC 2-114A, PO Box 20345, Houston, TX 77225, USA.
Insights
Developing a practical artificial heart remains a critical challenge. Current research explores both positive-displacement and continuous-flow pumps to improve cardiac support for heart disease patients.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Medical Device Development
Background:
- Heart disease is a leading cause of death, with a significant shortage of donor hearts for transplantation.
- Over 50 years of research has focused on developing a functional artificial heart to address this critical need.
- Early artificial hearts used positive-displacement pumps, offering hemodynamic support but facing challenges with size and durability.
Observation:
- Continuous-flow blood pumps with rotating impellers, initially developed for left ventricular assist devices, have been integrated into modern artificial hearts.
- These rotary pumps have achieved moderate clinical success, but their long-term impact is still under evaluation.
- The necessity of pulsatile circulation, characteristic of native hearts, in artificial heart function remains an open question.
Findings:
- Early positive-displacement artificial hearts provided short-term circulatory support but were limited by physical constraints and longevity.
- Modern total artificial hearts incorporating rotary pump technology show promise but have not fully overcome previous limitations.
- The clinical significance of maintaining pulsatile flow in artificial hearts requires further investigation.
Implications:
- Further research is essential to refine both positive-displacement and rotary total artificial heart designs.
- Optimizing artificial heart technology could significantly improve quality of life and survival rates for patients with end-stage heart failure.
- Understanding the role of pulsatile flow may guide the development of next-generation artificial hearts with enhanced physiological compatibility.
Abstract:
A practical artificial heart has been sought for >50 years. An increasing number of people succumb to heart disease each year, but the number of hearts available for transplantation remains small. Early total artificial hearts mimicked the pumping action of the native heart. These positive-displacement pumps could provide adequate haemodynamic support and maintain the human circulation for short periods, but large size and limited durability adversely affected recipients' quality of life. Subsequent research into left ventricular assist devices led to the use of continuous-flow blood pumps with rotating impellers. Researchers have attempted to integrate this technology into modern total artificial hearts with moderate clinical success. The importance of pulsatile circulation remains unclear. Future research is, therefore, needed into positive-displacement and rotary total artificial hearts.
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