Therapeutic and physiological artificial heart: future prospects

Current left ventricular assist devices (LVADs) have demonstrated admirable results. However, approximately one-fourth of the patients who require LVADs suffer from right heart failure and require additional right ventricular (RV) assist devices (RVADs). The RV failure impairs the splanchnic circulation, subsequently developing into multiorgan failure (MOF). An aggressive application of a biventricular assist device (BVAD) is the best way to avoid and treat MOF because the BVAD reduces splanchnic congestion. Also, because the BVAD allows retention of the natural heart, recovery of the heart function can be expected after long-term assist. This benefit cannot be expected from conventional total artificial hearts. Although there are no implantable clinical BVAD systems in existence today, present advanced technologies in rotary blood pumps can enable these systems to be totally implantable. So, we should focus on developing a totally implantable BVAD system. The implantable BVAD will be a therapeutic and physiological total artificial heart, and it will be a common home health care device in the near future.