Role of left ventricular assist devices in acute heart failure syndrome and the future of the replacement heart

Abstract

The first attempts to artificially sustain the circulation in modern times occurred with the development of the cardiopulmonary bypass machine by John Gibbon and later modified by John Kirklin in the mid-1950s 1,2. These early machines revolutionized the field of cardiac surgery, allowing complex repairs to be done while sustaining the circulation with cardiopulmonary bypass. About a decade later, the first pulsatile pumps were being used to assist the failing left ventricle, especially in patients with cardiogenic shock postcardiotomy3,4. These early reports encouraged scientists of the time, like Dr. Michael DeBakey, in a crusade to produce a device intended for long-term ventricular support5. By the late 1960s, with the birth of heart transplantation6, interest in mechanical assist devices waned. As the limitations of heart transplantation became apparent, especially the lack of adequate immunosuppression early on, renewed interest in mechanical ways of supporting the failing heart surged in the mid-1970s. © 2008 Springer-Verlag London.