The Artificial Heart: Prototypes, Policies, and Patients

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. Table of ContentsFront MatterExecutive Summary1. The Artificial Heart Program: Current Status and History2. Total Artificial Hearts: Technological Potential and Research and Development Costs3. Decisions for Future Research and Development4. Clinical Effectiveness and Need for Long-Term Circulatory Support5. Quality of Life and Mechanical Circulatory Support Systems6. Cost-Effectiveness Analysis7. The Appropriate Use of Technology8. Ethical and Societal Issues9. Roles of Government and Industry in Medical Technology Research, Development and Use10. Conclusions and RecommendationsAppendix A: History and Methods of This EvaluationAppendix B: A Chronology of the National Heart, Lung, and Blood Institute Artificial Heart Program and Related EventsAppendix C: Technological Opportunities and Barriers in the Development of Mechanical Circulatory Support SystemsAppendix D: Epidemiology of End-Stage Heart DiseaseAppendix E: Assessing the Cost-Effectiveness of the Development and Use of the Total Artificial HeartGlossaryIndex