Restoring Cardiac Function: An Emerging Spectrum of Therapeutic Options

A spectrum of techniques for restoring cardiac function is emerging. Among patients with global congestive heart failure (CHF), cardiac transplantation may help a small minority for whom allografts are available; the total artificial heart may eventually benefit a larger number. For patients with left-sided CHF, parallel-assist techniques maximally augment cardiac output. In-series techniques can help others without major arrhythmias and some residual cardiac output. As compared with parallel assist, in-series methods offer lesser hemodynamic augmentation but greater intrinsic reliability and the possibility of deactivation of support for hours or days without increased risk. Additional advantages include simplicity of management and documented long-term clinical efficacy.