We have conquered CAD with coronary stents ! really ? atleast , that is what , many of us are made to believe !
But , the fact is , modern cardiac science with all those fancy intra coronary devices has shifted the CAD population into cardiac failure population. We have extended the life of humans by at least few years and make them suffer recurrent coronary events and ultimately LV dysfunction and cardiac failure .
We know , cardiac failure can not be conquered with medicines and surgery . Cardiac transplant has been very successful , but it needs one human death to give one life to other , and “deaths” can not be bought in stores or donated at will !
So , the only alternative for terminal heart failure is total artificial heart.(Organ farming or cloning not included ) The research is going on for the past 50 years. We are definitely on the right track. By 2050 , my guess is no human being should die of heart failure .
Meanwhile , number of partial answers for failing hearts which are popularly referred to as LV assist devices are coming up.
In many cases the failing native heart supports the device in a mutual fashion thus extending the life of the device as well .This is important because in case of total artificial heart there is no back up available.
These axial LV pumps just augment the overall circulation status and in the process unloads the native heart and prolongs it’s running time.
In the future one may think about number of serial pumps in the circulatory system rather than a single bulky artificial heart which is fraught with serious maintenance issues.
The most promising one such device is from Germany
- A small AA battery sized tubular pump
- Weighs 25 grams
- Receives blood from left atrium pushes it into subcalvian artery
- Can have a stroke volume of 10-15cc /beat*
- Capacity to pump a cardiac output of 3l/mt (This amounts to 100% augmentation in most terminal heart failure patients)
- Can be implanted like a pacemaker
- Early clinical trials are promising (MIT review)
* There is little end diastolic residual blood in this pump .
Picutre courtesey www.medgadget.com
Link to http://www.circulite.net
Dr.S.Venkatesan MD 