Future of Mechanical Circulatory Support: New Systems on the Horizon

Current research and development activities in mechanical circulatory support are aimed at reducing adverse events and improving long-term outcomes. Innovative designs strive to be smaller, more durable, easier to implant, and to deliver improved hemocompatibility. New systems under development are classified as total artificial hearts (TAHs), implantable ventricular assist devices (VADs), percutaneous VADs, and aortic-flow VADs. The type of flow generated by these systems may be pulsatile, continuous, toroidal, or wave flow. Mechanical circulatory support technology under development ranges from temporary, catheter delivered, low-flow devices to complete cardiac replacement systems. In this era when the number of people with severe heart failure is expanding, new, future clinical trials will be set up to evaluate the safety and efficacy of these mechanical circulatory support systems.