Table of Contents
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Front Matter	i-xiv
Executive Summary	1-13	(skim)
1. The Artificial Heart Program: Current Status and History	14-25	(skim)
2. Total Artificial Hearts: Technological Potential and Research and Development Costs	26-43	(skim)
3. Decisions for Future Research and Development	44-64	(skim)
4. Clinical Effectiveness and Need for Long-Term Circulatory Support	65-84	(skim)
5. Quality of Life and Mechanical Circulatory Support Systems	85-106	(skim)
6. Cost-Effectiveness Analysis	107-120	(skim)
7. The Appropriate Use of Technology	121-134	(skim)
8. Ethical and Societal Issues	135-150	(skim)
9. Roles of Government and Industry in Medical Technology Research, Development and Use	151-172	(skim)
10. Conclusions and Recommendations	173-200	(skim)
Appendix A: History and Methods of This Evaluation	201-204	(skim)
Appendix B: A Chronology of the National Heart, Lung, and Blood Institute Artificial Heart Program and Related Events	205-210	(skim)
Appendix C: Technological Opportunities and Barriers in the Development of Mechanical Circulatory Support Systems	211-250	(skim)
Appendix D: Epidemiology of End-Stage Heart Disease	251-261	(skim)
Appendix E: Assessing the Cost-Effectiveness of the Development and Use of the Total Artificial Heart	262-284	(skim)
Glossary	285-288	(skim)
Index	289-298	(skim)

Description

A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program--and in particular, the National Institutes of Health's major investment--raising important questions.
The volume includes:

• Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments.
  
• A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions.
  
• Examination of how this technology's use can be targeted most appropriately.
  
• Attention to achieving access to this technology for all those who can benefit from it.
  

The committee also offers three mechanisms to aid in allocating research and development funds.

Authoring Organizations

• Institute of Medicine (IOM)
• More Titles from IOM

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NOTES

 

"From Explosives to the Gas that Heals" from the Beyond Discovery series