Current Durable Mechanical Circulatory Support Systems

Researchers and scientists have developed blood pumps to either support or replace the failing human heart, and to mimic the natural heart and produce a pulsatile blood flow. All mechanical blood pumps developed in the 1950s, 60s and 70s followed that concept. All pumps that supported the failing heart were initially placed outside of the body, connected with long cannulas to the large vessels. Because of infections along the percutaneous cannulas, implantable pumps placed inside the body were thought to overcome that problem. But these pumps still needed a connection to the driving units placed outside of the body. The design goals were to reduce the size of extremely large pulsatile blood pumps with electro-mechanical blood pumps that generate a continuous blood flow. All patients supported by continuous flow LVADs received anticoagulation medications, but thromboembolic events caused by tiny clot formations inside the pumps around the mechanical bearings of the rotor did occur. To mitigate this problem, the next generation of pumps replaced the mechanical bearings with a magnetic suspension of the rotor, meaning that the rotor is floating in a strong magnetic field inside the pump, never touching the pump housing during rotation at all. The HeartMate 3 utilizes a fully magnetically suspended rotor technology with wider gaps than prior pumps. A recent analysis of patients supported by the HeartMate 3 for over 5 years showed a cumulative mortality rate of only 38%, demonstrating a further narrowing gap between long-term outcomes of patients supported with latest pump support technology and heart transplantation. Today, the HeartMate 3 is the sole commercially available LVAD worldwide.