# The Past, Present, and Promising Future of Direct Cardiac Compression Devices

## TL;DR

New direct cardiac compression devices offer promising mechanical heart support without common complications like blood clots or bleeding.

## Contribution

The paper highlights recent advancements in DCC technology and its potential for clinical application in heart failure treatment.

## Key findings

- DCC devices provide effective mechanical cardiac support for up to one month.
- DCC avoids complications like thrombosis and bleeding due to no blood contact.
- Human clinical trials for DCC devices are now underway.

## Abstract

•Newly developed DCC devices provide effective systolic and diastolic MCS; support can be for the LV, for the RV, or for both ventricles.•Support of up to 1 month has been achieved.•Neither thrombotic complications nor bleeding complications after DCC have been observed.•DCC development is progressing rapidly and human clinical trials are beginning.•It is important that HF clinicians are aware of and understand this potentially important technology.

Newly developed DCC devices provide effective systolic and diastolic MCS; support can be for the LV, for the RV, or for both ventricles.

Support of up to 1 month has been achieved.

Neither thrombotic complications nor bleeding complications after DCC have been observed.

DCC development is progressing rapidly and human clinical trials are beginning.

It is important that HF clinicians are aware of and understand this potentially important technology.

Direct cardiac compression (DCC) devices, under development as a new modality for mechanical cardiac support (MCS), offer several advantages over presently available forms of MCS. DCC devices avoid the blood contact obligatory with other implantable MCS devices, the complications associated with blood contact and hematologic incompatibility, such as thrombosis, stroke, and the need for anticoagulation are avoided, and DCC does not require vascular access eliminating challenges such as bleeding and extremity ischemia. Arterial pressure pulsatility is also maintained with DCC. Significant and underappreciated advancements in DCC technology have occurred over the last decades with notable dramatic improvements in cardiac performance and minimal tissue damage. One device has entered clinical trials with a second device anticipated to follow. DCC is poorly understood by most cardiologists and cardiac surgeons. This review summarizes DCC development and advances so that upcoming human clinical trials can be properly assessed.