Preface

Dear colleagues and readers,

It is a great honor to serve as Guest Editors for the current issue of the Annals of Cardiothoracic Surgery (ACS). This issue focuses on mechanical circulatory support (MCS) as either a bridge to transplant or destination therapy.

It took only 40 years to progress from the first transoceanic flight (1927, Charles Lindbergh with the “Spirit of St. Louis”) to the first man to walk on the moon (1969, Neil Armstrong); conversely it took a little more than 40 years for an exceptional therapeutic option (1967, Christiaan Barnard with the first heart transplant) to vanish as a readily available therapeutic option because of the shortage of organ donors. This is due to the fact that organ donors nowadays are older and less acceptable.

Improved surgical techniques, improved device safety and durability have led to an increasing acceptance of MCS in the cardiac community.

It is therefore likely that we will see a broader acceptance of MCS in the future, due to the “pressure” of patients and referring cardiologists and most importantly due to the shortage of donor hearts. This trend is understandable, with patients experiencing improved survival with a pathology that, if only medically treated, would generate unfavorable results.

In parts I and II of the current issue, almost 30 manuscripts will cover a wide range of important topics in MCS. The surgical aspects of implantation are analyzed using step-by-step descriptions together with a collection of videos of the four most popular devices in use. Critical reviews together with original research demonstrate the great dynamism present in the field of MCS, which is a multidisciplinary world in which continuous collaboration among surgeons, cardiologists, and other specialists is required to manage all the possible complications that occur in daily practice.

Another extremely important article is the cost-utility analysis that will be presented in this issue that will lead to new debates between administrators and physicians.

We would like to take this opportunity to thank all contributing experts in the field of MCS for their efforts in putting together all the material. Without their invaluable help, this would not have been possible, and their enthusiasm in providing such monumental work has required the current issue to be presented in two parts (I and II) in order to include all the manuscripts.

We would also like to thank the Editorial team of the ACS for their continuous support, and especially to Prof. Tristan Yan, as the initiator of this outstanding Journal.