Novel Percutaneous Cardiac Assist Devices

Progress made in cardiovascular treatment over the past several decades has been impressive. Combined invasive and pharmacological treatment strategies have improved clinical outcome in patients undergoing percutaneous coronary intervention (PCI), as well as in those treated for acute myocardial infarction and decompensated heart failure. In the case of acute myocardial infarction, dramatic reductions in the progression to cardiogenic shock and the rates of reinfarction and mortality have been seen.1,–,3 In particular, in-hospital survival has improved by as much as 10 absolute percentage points, and cardiogenic shock after myocardial infarction has been cut in half.3,4 In addition, primary prevention strategies such as pharmacotherapy and aggressive risk factor modification have made significant headway in reducing the incidence of a first coronary event.4 Thus, not only do fewer patients present with acute myocardial infarction, but associated mortality has declined.The improved survival after myocardial infarction, however, has resulted in more patients living with systolic dysfunction and associated congestive heart failure.5 Heart failure, indeed, is now the major cardiovascular disease that drives hospital admissions and produces significant patient morbidity.6 This is not to say that progress has not been made in the realm of congestive heart failure, however. Both invasive (implantable devices and revascularization) and pharmacological (β-blockers and renin-angiotensin-aldosterone system antagonists) therapies have improved outcome, including quality of life, heart failure symptoms, ventricular function, and survival.7,–,10Finally, PCI outcomes have seen dramatic improvements since the initial angioplasties performed in the late 1970s. In particular, the development of bare metal stents and, more recently, drug-coated stents, modern angioplasty balloon catheters and equipment, and safer while more effective antiplatelet therapy has improved procedural success and reduced mortality.11 Indeed, patients with higher degrees of multivessel disease, as well as concomitant …