Which made him eligible for one of the most audacious experiments in re- cent medical history–the AbioCor, the world’s first fully implantable, plastic-and-titanium, battery-powered replacement heart. In a seven-hour operation last Monday, Gray and his colleague Dr. Robert Dowling cut out most of the man’s diseased heart and stitched what remained to the cuffs of the mechanical one. They made the elaborate electronic connections for power, control and monitoring, and then watched as blood went coursing into the aorta and pulmonary artery. By the end of last week the AbioCor had beaten more than a million times, and the patient, briefly taken off a respirator on Wednesday, was conscious and able to talk to his family. How long he will survive was still very much in doubt. The manufacturer, Abiomed Inc., of Danvers, Mass., has said it would consider a two-month survival a success. The patient could suffer infections, liver problems, stroke or many other things. Or his new heart could fail in some unanticipated way–but then again, his old heart was already failing.
The AbioCor is the most ambitious of a new generation of bionic organs; it was featured on the cover of NEWSWEEK’s June 25 issue, which is where the unnamed patient learned about it. Artificial hearts have been in poor repute since the unsuccessful experiments of the 1980s. Earlier models were powered by large external consoles connected to the device by tubes passing through the skin, posing a constant risk of infection. The AbioCor is contained within the body and runs off a battery system that transmits current through the skin without wires. In theory, the patient, if he recovers well enough, can resume normal activities, up to but not including jogging–not that he would need to jog to strengthen his artificial heart anyway.
Four more surgical teams around the country are training to implant AbioCor hearts as part of the initial clinical trial. At best, according to Dr. O. H. Frazier, chief transplant surgeon at the Texas Heart Institute, the AbioCor–which costs $75,000, not including surgery and follow-up care–would be approved for general use in two to three years. For now, candidates must be the size of an average man–ruling out children and many women–in order to fit the grapefruit-size AbioCor in their chests. They have to be willing to run the unforeseeable risks of a highly experimental procedure. And they have to have no more than 30 days left to live, with no other medical or surgical options available. As of the end of last week, the patient in Louisville was still an extremely sick man. But two days after the surgery, the AbioCor, thrumming away at 120 beats per minute, had cleared the fluid from his lungs.
All Pumped Up
The artificial hear that a middle-aged patient received last week was the first of its kind–fully implantable, with no large external power console. (diagram/graphic omitted)
