[Terminal cardiac failure. Circulatory assist devices]

Area of Science:

• Biomedical Engineering
• Cardiovascular Technology
• Medical Devices

Context:

• The clinical application of circulatory assist devices is diverse, influenced by patient age, performance requirements, and energy sources.
• Intra-aortic balloon counterpulsation represents the oldest form of circulatory assistance.
• Devices are broadly categorized into short-term, partial assistance systems and sophisticated, long-term machines.

Purpose:

• To review the variety of circulatory assist devices available for clinical applications.
• To categorize devices based on their function, duration of use, and power source.
• To highlight advancements in long-term circulatory support, particularly electrically powered systems.

Summary:

• Circulatory assist devices vary widely, from the traditional intra-aortic balloon counterpulsation to advanced systems like Hemo-pump, Centrifugal pumps, and pneumatically driven devices (Thoractec, Medos, TCI, Jarvik-CardioWest).
• Electrically powered ventricular assist devices, such as Novacor and HeartMate Systems, are implanted in the abdominal wall for long-term left ventricle assistance.
• These implantable devices enhance patient independence, paving the way for chronic use as an alternative to heart transplantation.

Impact:

• Technological advancements in circulatory assist devices are expanding options for patients with heart failure.
• Electrically powered implantable devices offer improved quality of life and independence for long-term cardiac support.
• The development of sophisticated assist devices provides viable alternatives to heart transplantation, addressing donor organ shortages.