title: [Assisted circulation: an overview from a clinical perspective].
abstract: A higher grade cardiac failure is associated with poor prognosis. In addition to medical conservative treatment and traditional cardiac surgery, in the past years different forms of an assisted circulation evolved. Short-term devices serve to bridge an acute life-threatening situation. The chosen system is dependent on the anticipated clinical course. It is possible to fall back on slightly assisting techniques up to a complete takeover of the cardiac pump function. In the case of severe cardiac failure, the question for transplantation has to be addressed because transplantation is the treatment of choice to date. For an assisted circulation in cases of chronic congestive failure, devices of different generations are available. First generation pulsatile systems are used for assistance of the left ventricle and results have been shown to be superior to medical therapy (REMATCH). With second generation continuous-flow systems, results regarding infections, thromboembolism and also quality of life appear to be further improved. Contact-free centrifugal pumps as third generation systems are in clinical evaluation. So-called "total artificial hearts" are successfully used for bridge-to-transplantation. Taken together, a graded safe treatment of cardiac failure is available today. In the near future, it could be possible to reach results similar to those of cardiac transplantation.
authors.affiliation: Klinik für Thorax-, Herz- und Gefässchirurgie, Universitätsklinikum RWTH Aachen, Aachen, Deutschland. jspillner@ukaachen.de
authors.forename: Jan
authors.initials: J
authors.lastname: Spillner
authors.forename: Rüdger
authors.initials: R
authors.lastname: Kopp
authors.forename: Thomas
authors.initials: T
authors.lastname: Finocchiaro
authors.forename: Mehdi
authors.initials: M
authors.lastname: Behbahani
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
authors.forename: Marek
authors.initials: M
authors.lastname: Behr
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Autschbach
mesh_terms: D001243:Assisted Circulation / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006333:Heart Failure / Q000517:prevention & control*; D006354:Heart, Artificial; D006801:Humans; D008020:Life Support Care / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000639:trends