History of circulatory assistance, technology at the service of medical progress

Abstract

Circulatory assistance, born from the observations of 18^th century physiologists, allowed the birth of cardiac surgery as we know it today. Adapted to get out of the operating room, these techniques have found their place in the intensive care unit for the treatment of refractory respiratory and cardiogenic failures. Transformed into long-term machines, they now accompany patients at home to subsequent heart transplant or as destination therapy. Gradually the machines were improved, allowing a more prolonged use and reducing hemorrhagic, hemolytic and infectious complications. Extracorporeal membrane oxygenation (ECMO), is nowadays the mainstay of short-term circulatory assistance. New indications are regularly emerging, allowing the treatment of patients previously considered incurable. Still, the place of these treatments in the management algorithms of acute and chronic cardiorespiratory failure has yet to be defined.