The Artificial Heart

A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program—and in particular, the National Institutes of Health's major investment—raising important questions.

The volume includes:

• Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments.
• A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions.
• Examination of how this technology's use can be targeted most appropriately.
• Attention to achieving access to this technology for all those who can benefit from it.

The committee also offers three mechanisms to aid in allocating research and development funds.

• Front Matter
• Executive Summary
• 1. The Artificial Heart Program: Current Status and History
• 2. Total Artificial Hearts: Technological Potential and Research and Development Costs
• 3. Decisions for Future Research and Development
• 4. Clinical Effectiveness and Need for Long-Term Circulatory Support
• 5. Quality of Life and Mechanical Circulatory Support Systems
• 6. Cost-Effectiveness Analysis
• 7. The Appropriate Use of Technology
• 8. Ethical and Societal Issues
• 9. Roles of Government and Industry in Medical Technology Research, Development and Use
• 10. Conclusions and Recommendations
• Appendix A: History and Methods of This Evaluation
• Appendix B: A Chronology of the National Heart, Lung, and Blood Institute Artificial Heart Program and Related Events
• Appendix C: Technological Opportunities and Barriers in the Development of Mechanical Circulatory Support Systems
• Appendix D: Epidemiology of End-Stage Heart Disease
• Appendix E: Assessing the Cost-Effectiveness of the Development and Use of the Total Artificial Heart
• Glossary
• Index