Tuesday July 3 5:50 PM ET
Artificial Heart May Offer New Hope
By PAUL RECER, AP Science Writer
WASHINGTON (AP) - A daring experiment testing a self-contained
mechanical heart offers new hope for thousands of Americans with failing
hearts, many of whom may die while waiting for transplants.
``This is the next step and it's a positive step'' in a decades-long
search for mechanical devices to assist people in end-stage heart
failure, said Dr. Robert S. Higgins, chairman of cardiology at the
Medical College of Virginia.
``This is something we've all been looking for,'' said Dr. John
Conte, head of the Johns Hopkins University Medical Center heart-lung
transplant program. ``I think it is wonderful - a great step forward.''
But the doctors are quick to emphasize that implanting the Abiomed
heart in an unidentified patient in Louisville does not mean that
replacement hearts will be ready immediately to take off the shelf and
install in dying patients.
They forecast it will take at least five years before the new device
is widely available - and then only if it proves itself in long-term use
among several dozen experimental patients.
``Some of the established cardiac surgeons will have to grow
comfortable with the reliability of this device,'' said Higgins, who
participated in development of an earlier mechanical heart that was
``People are dying for lack of donor organs,'' said Dr. Timothy J.
Gardner, head of heart surgery at the University of Pennsylvania medical
center in Philadelphia. ``We have yet to come up with a mechanical
device that gives the quality of life that makes it all worthwhile. This
may be the one, but that's yet to be proven.''
Dr. O. H. Frazier, chief of cardiopulmonary transplant at the Texas
Heart Institute in Houston, said he was ready to use the device now to
``People who would receive the devices really have no other
options,'' he said. ``It could rescue them from certain death.''
Frazier said he expects that about 10 of the devices will be
installed and the cardiac surgery community will then closely examine
the results before widening the circle of surgeons who use them.
For surgeons, said Frazier, who has put the Abicor device in calves,
``it is technically not that tough. It does require some training, but
it is not that tough.''
Dr. Clyde W. Yancy Jr., head of the St. Paul's Medical Center
transplant program which is affiliated with the University of Texas
Southwest Medical Center, said that the emotional-mental-social elements
of a mechanical heart ``may be the biggest problem.''
``How does a patient respond to having a totally artificial system in
place?'' asked Yancy. ``How are the patient and the family members going
These questions must be answered, he said, before a mechanical heart
can assume an essential role in medicine.
Right now, about 46,000 Americans die annually of heart failure.
About half of these die suddenly and can never benefit from heart
surgery or replacement. Last year, there were more than 4,200 patients
on lists waiting for donor hearts, but only about half ever received an
organ. The rest die waiting.
Only about a tenth of those with end-stage heart disease are good
candidates for heart transplant, doctors say.
``A transplantation requires intensive compliance,'' said Gardner.
This means that to be successful, a patient must have a dedicated
determination to take the required medicines, get the required blood
tests and stick to the diet and exercise regimen ordered by the doctor.
Many patients with end-stage heart disease also suffer from other
organ failures or lack the domestic support resources required by
It is possible, said Gardner, that a dependable mechanical heart will
not have the same rigid requirements, thus making more people eligible
for life-sustaining heart replacement surgery.
But Higgins said that even if the new device appears to work well, it
is unlikely to soon replace the demand for donor hearts.
``A donor heart in a good transplant can last 15 to 30 years,'' he
said. ``It's going to be hard to replace that with a machine.''