Different mechanical circulatory support systems (MCSS) have been in c
linical use since 1987 to keep patients alive by assisting the heart d
uring cardiac recovery after open heart surgery, myocardial infarction
, acute graft failure after heart transplantation, or as a bridge to t
ransplantation in heart transplant candidates. Four different hospital
s in Germany used the Berlin Heart Assist Device. Up until 1993, there
were 22 patients in the ''recovery'' group; 4 patients were weaned fr
om the system, and only 1 patient was discharged from the hospital. In
112 patients the Berlin Heart Assist Device was implanted for the pur
pose of a bridge to transplantation, 68 were transplanted and 46 patie
nts left the hospital. It was concluded that patients may be kept aliv
e with this system for weeks and months after any kind of cardiogenic
shock. Complete cardiac recovery may be achieved in patients with earl
y posttransplant graft failure. Reliable prediction of outcome in brid
ge-to-transplantation patients requires further experience and improve
ment of system components.