Evaluation of healing process and biocompatibility in artificial organs

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The current situation and future perspectives of rotary blood pumps were overviewed from the standpoint of three different assist modes : paracorporeal, implantable, and percutaneous. For the paracorporeal mode, the use of the centrifugal pump in open-heart surgery has begun to decline in the United States because of the small cost benefit. To reverse this trend and save the centrifugal pump for its largest market in this era of "cost matters more than quality, " further cost reduction along with intentional expansion of the clinical applications and the development of a "minimally invasive cardiopulmonary system, " with a revolutionary concept, are important. As for paracorporeal venoarterial bypass with an oxygenator, a two-week pump is sufficient because the assist mode itself has essential problems, such as inadequate left heart decompression and morbidity associated with the oxygenator or percutaneous cannula. For implantable pumps, it is true that rotary blood pumps have many attractive advantages over pulsatile pumps, such as compactness, lower developmental and manufacturing costs and ease of the implantation procedure. However, no one is quite sure what the pathophysiological effects of non-pulsatile now are on humans. Pulsatile flow may be mandatory during the initial recovery period from shock or in patients with significant atherosclerosis of the brain or kidneys. The regulation of the pump flow may be another point to be investigated. We have to admit there is strong competition with the various pulsatile implantable pumps that have already been used in thousands of patients. The percutaneous approach may be the most attractive, yet most neglected, field for rotary blood pumps. To cover the wide gap between the intraaortic balloon pump and implantable pumps, we should develop a safe and reliable percutaneous left ventricular assist pump, which is impossible with a pulsatile pump.