Cardiac assist devices, also known as heart pumps, are mechanical pumps that are used to partially or completely replace the function of a failing heart. They help improve the heart's ability to pump blood throughout the body and supply vital organs with oxygen-rich blood. There are various types of cardiac assist devices available today which can be implanted either temporarily or permanently depending on the condition of the patient.

Limitations and Complications

While cardiac assist devices provide a new lease of life, they are not without risks. Some potential limitations and complications include:

- Bleeding: Due to use of blood thinners which increase risk of hemorrhage. Gastrointestinal bleeding is a common complication.

- Infection: Driveline and pump pocket infections can occur despite use of antibiotics and sterile techniques.

- Thromboembolism: Formation of blood clots in the device which can dislodge and block arteries is a concern.

- Device malfunction: Mechanical failures, component wear are issues, especially with older devices requiring reoperation.

- Neurologic problems: Stroke risk exists due to debris entering circulation from the device or aorta.

- right heart failure: Pulmonary hypertension and RV failure can still occur long-term despite LVAD support.

- Operator dependency: Reliance on trained staff for device monitoring and management post-discharge.

Future of Cardiac Assist Devices

With ongoing technological advances, newer generations of smaller, more durable and easier to use Cardiac Assist Devices are being developed and tested. Some areas showing promise include:

- Wireless and implantable pumps to avoid driveline infections.

- Use of non-blood contacting designs and biomaterials to reduce thrombosis.

- Pediatric VAD options tuned for growth and physiology of children.

- All-in-one devices eliminating need for external components are under trial.

- Hybrid assist devices that assist both ventricles through a single cannula.

- Eventually, development of a fully implantable Total Artificial Heart that can last decades.

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