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After decades of laboratory investigations mechanical circulatory
support for the failing heart has entered the clinical arena.
Today, a growing number of patients with progressive myocardial
failure awaiting cardiac transplantation is successfully bridged to
transplantation with ventricular assist devices. The proceedings of
the "Mechanical Circulatory Support"-meeting, held in Berlin,
October 21-22, 1995, present new aspects of mechanical circulatory
support, recent experience with MCS in newborns and children using
specially developed small devices, and the results of long-term
mechanical assistance. The ability of the myocardium to recover
under pressure de-loading and reduced workload is discussed. All
these topics open up new perspectives for the use of mechanical
circulatory support, not only as a bridge to transplantation, but
also as a definitive approach for treating patients with end-stage
heart failure. Some of these concepts may even provide real
alternatives to heart transplantation, these being sorely needed in
light of the severe donor organ shortage. Regulatory as well as
ethical aspects of the extended use of mechanical circulatory
support systems and new technical developments in the field are
discussed by internationally distinguished experts.
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