Cardiac assist devices

In 1964 the U.S. Congress budgeted $581,000 to establish an artificial heart program at the National Institutes of Health (NIH). This was the first large-scale effort by any nation to support systematic research into the development of an artificial heart. The effort to build a reliable, totally implantable artificial heart has yielded marginal results. But even though an effective device does not exist, the artificial heart has, since the 1960s, been at the center of a heated ethical, economic, and policy debate. The debate over the wisdom of building and testing an artificial heart has also served as a paradigm for debating the future of expensive technologies in the U.S. healthcare system.

Scientists and physicians in many countries have dreamed for centuries of curing fatal heart diseases by creating a mechanical substitute. Technological advances during the 1960s in engineering fields such as metallurgy, fluid dynamics, electronics, and computer modeling made some scientists think that it might be possible to actually construct such a device. The emergence of the kidney dialysis machine, which could mimic the functions of a human kidney, created a fundamental change in attitude in medicine about the feasibility of building an artificial heart. In the late twentieth century, the quest for the Totally Implantable Artificial Heart (TAH) was once again the catalyst for other technological advances; except for the TAH, the success of the artificial heart program to date is still up for debate.

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