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Surgeons prep for implanting artificial heart
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BY DAN GORDON
UCLA Today
As the first human recipient of a fully self-contained artificial heart introduced himself to the world earlier this week, a UCLA Medical Center team prepared for the possibility that it would implant the second patient, perhaps as early as next month.
Robert Tools, 59, was given fewer than 30 days to live before he was implanted with the titanium-and-plastic, battery-powered device known as AbioCor on July 2 at Jewish Hospital in Louisville, Ky. He has survived more than seven weeks with minimal complications.
"This artificial heart has not been used in animals for more than a few weeks, so there's not a lot known about its long-term function," said Hillel Laks, chief of cardiothoracic surgery and director of the Heart and Lung Transplant Program at UCLA. "But from what we've seen so far, one would expect that this patient, once recovered, could go on living for a year and possibly several years."
A spokeswoman for Abiomed, the Massachusetts company that developed and manufactures AbioCor, said it has not been decided who the next recipient will be, when the next operation might occur or where it will take place. UCLA Medical Center is one of five hospitals approved by the Food and Drug Administration to implant the device in near-death heart failure patients who are ineligible for transplantation.
UCLA has completed the required animal implants and training of surgeons and staff, and Laks said Abiomed has indicated UCLA will likely be one of the next two centers it recommends to perform the second implant. Once that occurs, candidates will be screened for the experimental procedure.
AbioCor, which is implanted in the chest cavity in place of the diseased heart, weighs two pounds and is four inches in diameter, with a motor that performs the heart's task of circulating blood through the body. The motor is powered by an implanted battery that is recharged through the skin by an external battery pack carried by the patient. The pace of the pumping is altered to meet blood flow demands as the patient's level of exertion changes.
Although heart transplantation has saved numerous lives, the numbers are stacked against transplant candidates. Approximately 50,000 Americans are in need of a new heart, but only 2,400 donor hearts become available each year, and half the people on the transplant waiting list die before their names come up.
"If this heart functions well and gives a good quality of life, it could solve the problem of the shortage of donor hearts for many thousands of patients," said Laks, whose heart transplant program is the nation's largest.
Artificial hearts naturally raise certain concerns, he noted. There is the potential for blood to clot when exposed to non-biological surfaces; when that risk is countered by the use of blood-thinning drugs, there is a greater chance for bleeding or other complications. In addition, foreign material circulating in the bloodstream might increase the risk of infection. The possibility of eventual mechanical failure is also a concern.
"All of these things will have to be evaluated," Laks said. But he added that the UCLA team has already learned a great deal from following the progress of the Louisville patient, "and every week that goes by, we learn more." |
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