Artificial heart and left ventricular assist devices.

We believe there will be a place in cardiac surgery for a variety of assist and replacement devices. The extracorporeal assist devices, with or without extracorporeal membrane oxygenation, will be needed for acute situations requiring time for diagnosis and prognosis to be determined. There will also be a place for intrathoracic paraventricular assist devices that may temporarily or permanently support the right or left ventricle. Finally, we believe that there will be a number of patients whose native cardiac function is of no help at all and whose hearts probably should be removed to make room for an improved blood pump of human design. Pneumatic ventricles are presently available and we should see increasing use of them over the next couple of years. The convenience for a patient of electrical wires instead of pneumatic hoses coming out of the chest is obvious. However, the complexity and cost of the overall system is considerably greater, further testing and development is needed. Dr. William Pierce already has kept an animal alive for over 6 months with an electrically driven heart. Clearly, the electrically driven systems are the pumps for the next decade.