ABSTRACT
During the past 10 years, various modes of mechanical circulatory support have been used clinically to successfully restore homeostasis, improve end-organ function, and serve as a bridge to transplantation or recovery. The true longterm goal, however, once the technology has adequately evolved, is to use cardiac assist devices as destination therapy. Currently available ventricular assist devices (VADs) include extracorporeal membrane oxygenation (ECMO), extracorporeal pulsatile assist devices, implantable assist devices, and the total artificial heart (TAH). Some of these devices provide either univentricular or biventricular support (Thoratec1, ABIOMED1); others provide only left ventricular (LV) assistance [HeartMate1 (Thoratec Corporation, Berkley, California, U.S.A.) and Novacor1
(WorldHeart Inc., Oakland, California, U.S.A.)]. ECMO and the TAH [CardioWestTM (SynCardia Systems Inc., Tucson, Arizona, U.S.A.)] provide total circulatory support. Current experimental devices include axial flow impeller pumps (Jarvik 20001, HeartMate II1, NASA/ DeBakey VADTM) and a fully implantable electric TAH [AbioCor1 (ABIOMED, Inc., Danvers, Massachusetts, U.S.A.)]. This chapter will briefly describe the functional characteristics of ECMO and the various VADs; it will also explain the complications associated with each.
