The Past, Present, and Promising Future of Direct Cardiac Compression Devices

Direct cardiac compression (DCC) devices, under development as a new modality for mechanical cardiac support (MCS), offer several advantages over presently available forms of MCS. DCC devices avoid the blood contact obligatory with other implantable MCS devices, the complications associated with blood contact and hematologic incompatibility, such as thrombosis, stroke, and the need for anticoagulation are avoided, and DCC does not require vascular access eliminating challenges such as bleeding and extremity ischemia. Arterial pressure pulsatility is also maintained with DCC. Significant and underappreciated advancements in DCC technology have occurred over the last decades with notable dramatic improvements in cardiac performance and minimal tissue damage. One device has entered clinical trials with a second device anticipated to follow. DCC is poorly understood by most cardiologists and cardiac surgeons. This review summarizes DCC development and advances so that upcoming human clinical trials can be properly assessed.