A Historical Review of Mechanical Circulatory Support

Abstract

Meaningful and contemporary data regarding the clinical use of mechanical circulatory support (MCS) is founded on the work conducted in the 1950s when a “heart-lung” machine was incorporated to provide support during surgical interventions. Following this milestone, the need to support artificial circulation in patients with heart failure initiated an investigational and legislative collaboration to implement the mission-oriented Artificial Heart Program in the United States during the 1960s. In the subsequent decades, technological discoveries have integrated a series of mechanical systems employed as therapeutic options for short- and long-term artificial circulation in children and adults with advanced heart failure. Since their clinical application, MCS devices have been employed as a bridge to transplantation in over 4000 patients globally. In recent years, the adverse effects and economic burden of MCS have been counterbalanced by the harmonization of therapeutic protocols, the inclusion of multidisciplinary insight, and the allowance of families and patients to participate in shared decision making to address candidacy. In this chapter, we provide a review of the historical aspects of MCS, a therapeutic option for overcoming complexities encountered in reestablishing adequate hemodynamic states and providing a reasonable quality of life.

Unveiling the future of cardiac care: advances in mechanical circulatory support

“…The National Institute of Health initiated its artificial heart program in 1964 to advance the development of both partial and complete cardiac replacement systems [14]. This initiative coincided with efforts in Cleveland and Texas to pioneer circulatory replacement systems.…”

“…Notably, at Baylor University in Houston, Texas, William DeBakey performed the first human implantation of a left ventricular assist device (LVAD) in 1963 (Fig. 1), although the patient succumbed four days later [14]. In 1969, Denton Cooley sustained a human patient on support for 64 hours before transplantation, but unfortunately, the patient passed away 32 hours post-transplant due to pneumonia [14].…”

“…1), although the patient succumbed four days later [14]. In 1969, Denton Cooley sustained a human patient on support for 64 hours before transplantation, but unfortunately, the patient passed away 32 hours post-transplant due to pneumonia [14]. Cooley's pump, featuring two chambers and an external pneumatic driver, operated on the same principle as contemporary designs.…”

“…Cooley's pump, featuring two chambers and an external pneumatic driver, operated on the same principle as contemporary designs. Twelve years later, Cooley refined his pump and implanted a second artificial heart, a pneumatic dual-chambered Akutsu Total Artificial Heart (TAH), with the patient surviving 39 hours post-implant [14]. Public attention was first drawn to MCS with the successful implantation of the Jarvik-7 total artificial heart (TAH) (Fig.…”