Developing a reliable, permanent artificial heart for human patients may be years away, but doctors at Utah’s Intermountain Healthcare say recent advances in technology have nonetheless revolutionized the field.
“These people, you used to take care of them, and they just died. And now there’s this light at the end of the tunnel,” said Brad Rasmusson, medical director within Intermountain’s Thoracic Intensive Care Unit and one of the founders of the Utah Artificial Heart Program, which is celebrating its 25-year anniversary with a patient reunion this week.
Though Brent Haupt had no known heart conditions at the time, he collapsed while riding his bicycle in 2011. After two years of failed attempts to keep his heart going with medication, pacemakers and other steps, Haupt’s doctors told him he was going to need a heart transplant
But, they said, no organs were immediately available. Haupt would live in the hospital for nearly eight months without a beating heart.
Doctors at Intermountain Medical Center in Murray replaced his heart with a temporary mechanical unit, powered by a machine the size of a backpack. That allowed Haupt to walk around and enjoy some quality of life while he waited for his transplant — though he still wasn’t allowed to leave the hospital.
Had Haupt’s heart failed in the early 2000s, doctors said, he would have been largely confined to a hospital bed while he waited for a donor organ, his artificial heart connected to a much larger machine nicknamed “Big Blue.”
Had the failure occurred two decades before, Haupt probably would have died. Instead, on Tuesday he said that since the transplant, he has been able to do most everything he did before the 2011 incident.
A history of life-saving
Utah’s history with artificial hearts, of course, reaches back to 1982, when the world’s first permanent artificial heart was implanted in patient Barney Clark on Dec. 2 at the University of Utah Hospital.
That procedure, by cardiothoracic surgeon William DeVries, used a device named the Jarvik-7, after U. physician and inventor Robert Jarvik, in what has grown into the U.’s pioneering cardiac mechanical support and heart and lung transplant services at its Salt Lake City campus.
On Tuesday, Intermountain’s specialists said that since 1993, what is now known as the Intermountain Medical Center Artificial Heart Program has implanted more than 600 patients with some form of device to support heart function.
Most of these devices are assistive pumps that take some of the physical load off a patient’s ailing natural heart and extending its life, Rasmusson said. In some cases, patients are able to return home and live out their days with these assist devices, which are implanted in the patient’s chest and powered by external batteries that can be worn or carried in a briefcase.
In some cases, the heart is too damaged to function even with device assistance and these patients — including Haupt — now receive total artificial hearts. But even those are a temporary solution, Rasmusson said, and patients are still hospital-bound while using them.
Like assist devices, total artificial hearts are implanted in the patient’s chest, but must be connected to an external power source. Those connections can lead to dangerous infections, Rasmusson said, that make returning home a problem. In addition, he said, patients with artificial hearts tend to have difficulty with blood clotting, which can cause strokes and other complications.
Still, Rasmusson said, this represents a significant improvement over technologies available in the 1990s, when the artificial heart program began. Back then, total artificial heart implants were so large and heavy, they sometimes risked rupturing surgery incisions.
First-generation implants also tended to have more even problems with clotting and wore out quickly, sometime requiring frequent surgeries to replace the devices while the patient waited for a transplant.
Emerging technologies could help to address those challenges, too, doctors said. One involves internal batteries that could be recharged wirelessly through the chest wall, with potential to allow recipients of total artificial heart replacements more mobility to live fuller lives while waiting for a real heart.