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February 12, 1988

Artificial Heart Implantation: What Limitations Are Imposed by Infectious Complications?

Author Affiliations

New England Deaconess Hospital Harvard Medical School Boston

New England Deaconess Hospital Harvard Medical School Boston

JAMA. 1988;259(6):894-895. doi:10.1001/jama.1988.03720060062033

Recently, the interests and efforts of the scientific community to support or replace the severely dysfunctioning heart for variable periods have focused on the implantable total artificial heart (TAH) and the mechanical ventricular assist pump (VAP). Despite important technical advances in biomaterials, in the mechanical aspects of the devices, and in power sources, life-threatening thromboembolic, hemorrhagic, and infectious complications were promptly noted in association with use of these devices. Furthermore, use of the TAH was made difficult by the limited space available for its implantation within the thorax, while use of the VAP was restricted by its extracorporeal placement. Concurrent with the efforts to develop these mechanical devices, orthotopic cardiac transplantation became a reality. By the end of 1985, an international registry reported that 2577 patients had received cardiac transplants and that four-year survival among those heart recipients treated with cyclosporine was, by actuarial analysis, 76%.1 The successes of