The development of an implantable, portable, electrically powered left ventricular assist device

The development of the portable, electrically powered LVAD was a complex process that began in the early 1970s with the left ventricular assist project sponsored by the National Institutes of Health. The problems that DeBakey outlined in 1971 that challenged widespread clinical use of a ventricular assist device have today largely been solved by the TCI portable, electrically powered LVAD. The cost of LVAD implantation and maintenance, although still considerable, is less than the cost of caring for a patient in an intensive care unit for 75 days (the median waiting time in 1992 for a UNOS Status I candidate [UNOS, personal communication, 1994]) and comparable with the cost of other devices in use, such as the internal defibrillator. Although the implantation of the LVAD still requires a major operation, it is now a commonly performed procedure in transplant centers that use LVADs, and the level of operative risk is considered acceptable. The operation to implant an LVAD is usually performed in patients for whom death is imminent, and the potential benefit to such patients is high in relation to the risk of the surgical procedure. DeBakey feared that textured blood-contacting surfaces might not be suitable over long periods, but this has not been the case.(ABSTRACT TRUNCATED AT 250 WORDS)