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[Artificial organs and surgery. Present status and problems. The artificial heart].

T Akutsu

    Nihon Geka Gakkai Zasshi
    |September 1, 1985
    PubMed
    Summary
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    Surgical options for heart failure range from intra-aortic balloon pumping (IABP) to ventricular assist devices (VADs). For severe cases, the total artificial heart (TAH) offers a final solution when other devices fail.

    Area of Science:

    • Cardiovascular Surgery
    • Medical Devices
    • Heart Failure Management

    Context:

    • Surgical interventions are crucial for managing end-stage heart failure.
    • A spectrum of mechanical circulatory support devices exists, varying in complexity and application.

    Purpose:

    • To review and compare surgical options for cardiac assistance, including intra-aortic balloon pumping (IABP), veno-arterial bypass (VAB), ventricular assist devices (VADs), and the total artificial heart (TAH).
    • To highlight the progression of treatment from temporary support to permanent solutions for severe cardiac failure.

    Summary:

    • Intra-aortic balloon pumping (IABP) offers limited cardiac output increase (<1.0 L/min). Veno-arterial bypass (VAB) has shown poor results.
    • Ventricular assist devices (VADs) have been implanted in over 200 cases globally, with a 15.8% discharge rate; recent outcomes show steady improvement.

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  • The total artificial heart (TAH) has been used in five patients, initially as a bridge to transplant and more recently as a permanent solution, emphasizing the critical nature of timely application.

    • Impact:

    • Provides a comparative overview of mechanical circulatory support systems for heart failure.
    • Underscores the evolving role and improving outcomes of VADs and TAH in cardiac care.
    • Emphasizes the critical importance of precise timing in selecting the appropriate surgical intervention for failing hearts.