Two BASIC approaches to the development of an "artificial heart" have been introduced by several groups of investigators: total replacement of the diseased heart by pumps contained within the vacated pericardial space1-8 and intrathoracic bypass pumps which divert the flow of blood past the diseased ventricle or ventricles, thus reducing the flow work9,10 (Fig 1). The inlet of such a pump is anastomosed to the left atrium and the outlet is anastomosed to the aorta. Inlet (mitral) and outlet (aortic) prosthetic valves must be provided to assume the function of mitral and aortic valves respectively.
A third basic approach is presented in this study (Fig 2). The prosthetic ventricle serves to reduce the pressure against which the disease ventricle must eject its stroke volume to the extent that the diseased ventricle is performing the function of an auxiliary left atrium. The pressure work of the physiologic ventricle is