Mechanical Circulatory Support in Patients with End-Stage Heart Failure: a Literature Review (Part 2)

This article reviews modern technologies for durable mechanical circulatory support (dMCS) —implantable devices that replace or support cardiac function.

The process of improving circulatory support devices has spanned several decades. We have evolved from bulky first-generation pulsatile pumps to compact and reliable non-pulsatile flow pumps. Today, these highly effective systems are used in 95% of cases. Modern devices can serve not only as a bridge to heart transplantation for patients awaiting a donor organ, but also as ongoing therapy for patients who are not eligible for a heart transplant.

At the same time, trends toward improving the quality of medical care are also impacting the refinement of existing circulatory support techniques: minimally invasive devices for full and partial cardiac support are being developed; fully magnetically levitated centrifugal-flow left ventricular assist devices are becoming dominant; solutions for right ventricular and biventricular failure, including the total artificial heart, are emerging.

Sputnik portable circulatory support devices and STREAM CARDIO systems have been developed and are being used in Russia. They are comparable in efficacy and safety to their foreign counterparts, and in some respects (for example, antithrombogenic coating) they are superior. Their main advantage is their significantly lower cost and accessibility for Russian patients, which is critically important given the shortage of donor organs and the high cost of imported systems.

DMCS has become a life-saving and life-preserving standard practice in cardiac surgery. Given current demographic conditions, the growing proportion of patients with heart failure, and the chronic shortage of donor organs, further development and cost reduction of the aforementioned technologies is a strategic necessity for this country.

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