The artificial heart--1986: partial fulfillment of a promise.

While certain critically ill patients who are awaiting cardiac transplantation can be stabilized with either drugs, the intraaortic balloon pump, or a left ventricular assist device, other patients do not respond to these therapies and the use of a safe and effective artificial heart can be lifesaving. For this latter group, the pneumatic heart appears to be suitable, although minor improvements will be welcomed. The percutaneous tubes and bulky drive unit are not great disadvantages to the patient who uses an interim heart and remains in a constant care area. The patient with end-stage heart disease who cannot have a heart transplant has little hope at present. Interestingly, the pneumatic heart that is available now might be an acceptable alternative to death if the incidence of stroke could be overcome. In the future, these patients will be better served by either an electrically powered left ventricular assist pump or a totally artificial heart.