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.
 
                                                    
                                                        - Cover
 - Front Matter
 - Executive Summary
 - 1. The Artificial Heart Program: Current Status and History
 - 2. Total Artificial Hearts: Technological Potential and Research and Development Costs
 - 3. Decisions for Future Research and Development
 - 4. Clinical Effectiveness and Need for Long-Term Circulatory Support
 - 5. Quality of Life and Mechanical Circulatory Support Systems
 - 6. Cost-Effectiveness Analysis
 - 7. The Appropriate Use of Technology
 - 8. Ethical and Societal Issues
 - 9. Roles of Government and Industry in Medical Technology Research, Development and Use
 - 10. Conclusions and Recommendations
 - Appendix A: History and Methods of This Evaluation
 - Appendix B: A Chronology of the National Heart, Lung, and Blood Institute Artificial Heart Program and Related Events
 - Appendix C: Technological Opportunities and Barriers in the Development of Mechanical Circulatory Support Systems
 - Appendix D: Epidemiology of End-Stage Heart Disease
 - Appendix E: Assessing the Cost-Effectiveness of the Development and Use of the Total Artificial Heart
 - Glossary
 - Index