Mechanical Circulatory Support Program

The Massachusetts General Hospital Mechanical Circulatory Support Program provides comprehensive evaluation and treatment options to patients who may need devices to help with heart functionality.

What are Mechanical Circulatory Support Devices?

The Mechanical Circulatory Support Program at Massachusetts General Hospital comprises a multidisciplinary team of leading clinicians who carefully consider a wide array of MCS options to meet a patient’s individual needs.

Mechanical circulatory support (MCS) devices are used in circumstances when the heart is not able to pump properly and provide enough nutrients and oxygen to other organs. For patients with heart failure, or who are awaiting heart transplantation, these devices can offer significant support and improve their quality of life.

MCS devices are treatment options for patients:

• In need of temporary support devices after a heart attack or during a high-risk cardiac procedure
• Awaiting heart transplant who require durable MCS devices as a bridge to transplant
• With advanced heart failure who are not eligible for a heart transplant and need durable MCS for destination therapy

MCS as a Temporary Support Device

Temporary support devices are options for patients who have had a heart attack or are undergoing a high-risk cardiac procedure. These devices, such as an intra-aortic balloon, can be implanted through a catheter in the groin and positioned in the aorta; by pumping with each heart beat, it can improve the amount of blood that that heart is able to pump. Other forms of surgically implanted pumps, such as the Impella 5.0® and Centrimag®, provide even more support to the heart’s pumping function.

For patients in need of heart and lung support, extra corporeal membrane oxygenation (ECMO) can fully support the circulatory needs of critically ill heart failure patients while also performing the work of the lungs as necessary.

MCS as a Bridge to Transplantation

Heart transplantation is the only curative treatment for end-stage heart failure. However, the number of people who need new hearts greatly exceeds the number of heart donors—a gap that continues to grow. As demand increases and donor hearts remain in short supply, average waiting times for new hearts may lengthen from months to a year or more.

The left ventricle is the heart chamber responsible for pumping oxygen-rich blood to other organs. Left ventricular assist devices (LVADS) help to reduce the workload of the ventricle and assist in delivering adequate blood supply to all organ systems. Surgically implanted durable mechanical pumps can help to improve functional capacity, quality of life and survival in patients awaiting heart transplantation. 

In 2013, the majority of our patients undergoing transplantation were successfully bridged to transplantation with an LVAD. The Mass General MCS Program currently uses HeartWare® and Heartmate II® LVADs as durable support devices and recently added Syncardia Total Artificial Heart. Patients are able to await transplantation outside of the hospital with these devices, and many of our patients are able to return to work and engage in exercise programs. We are also investigating minimally invasive implantation techniques, in an effort to reduce recovery time and return to activity.