building a better heart second chance: artificial heart qing ye department of cardiothoracic surgery...
TRANSCRIPT
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Building A Better HeartSecond Chance: artificial heart
Qing YeDepartment of Cardiothoracic Su
rgery Ren Ji Hospital
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Milestones in artificial heart
• 1953, a heart-lung machine designed by Dr. John
Gibbon is used in a successful open-heart surgery,
demonstrating that an artificial device can
temporarily mimic the functions of the heart
• 1955, a team of scientists led by Willem Kolff,
tested their model in animals
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• 1964, the National Heart, Lung and Blood
Institute sets a goal of designing a total artificial
heart by 1970
•1966, Dr. Michael
DeBakey of Houston
successfully implants a
partial artificial heart
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• 1967, Dr. Christiaan Barnard performs the first successful
human heart transplant. The patients, 53-year-old dentist
Louis Washkansky, dies 18 days after surgery in South
African
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• In 1969, a team led by
Denton Cooley of the
Texas Heart Institute
successfully kept a human
patient alive for more than
sixty hours with their
model (temporary). The
patient gets a heart
transplant three days later
but then dies 1 ½ days
afterward
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• In 1982, a team led by William DeVries of the University
of Utah implanted the Jarvik-7 into a patient named
Barney Clark, who survived with Jarvik-7 for 112 days
• 1982-1985, Dr. William DeVries carries out a series of
five implants of the Jarvik total artificial heart
• William Schroeder, lived 620 days, dying in
August 1986 at age 54
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• 1994, the Food and Drug Administration approves the Left Ventricular Assist Device, which helps failing hearts continue to function
• 2000, A man in Isreal becomes the first recipient of the Jarvik 2000, the first total artificial heart that can maintain blood flow in addition to generating a pulse
• 2001, doctors at Jewish Hospital in Louisville, Ky., implant the first self-contained, mechanical heart replacement into a patient • Two recipient: Robert Tools & Tom Christerson
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Robert Jarvik
• He was born in Michigan
on May 11, 1946
• In 1964, his father became
ill with heart disease and
had to have open heart
surgery
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Robert Jarvik
• Jarvik became very interested in medicine at that point and began to think about possible designs for artificial hearts that could help people like his father
• He invented Jarvik-7 and Jarvik-2000
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Jarvik-7
Jarvik 2000
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Prof. Willem J Kolff
• He was born in Leiden,
Netherlands
• Graduated from the
University of Leiden
• In 1955, he implanted an
artificial heart into a dog
• Tutor of Dr. Robert
Jarvik
• 1981, he applied to FDA
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Dr. William deVries
• An American cardiothoracic
surgeon• Receiving his MD degree from the University of Utah in 1970• As a resident in cardiovascular/
thoracic surgery at Duke University Medical Center• Assistant professor of surgery at the University of Utah until 1984
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Dr. William deVries
• Since 1984, he has been
director of the artificial heart
project of the Humana Hospital
Audubon in Louisville,
Kentucky• Performed the first successful
permanent artificial heart
implant for Barney Clark by
using an artificial device
designed by Dr. Robert Jarvik
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Dr. Barney Clark
• An 61year old retired
dentist from Seattle
• First recipient of the
man-made artificial
heart on Dec 1, 1982 at
the Utah Medical
Center
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Dr. Barney Clark
• Six years before the transplant,
he had contracted a mysterious
viral infection, which made his
cardiac muscle flabby, weak
and swollen from a lack of
blood flow• Because of hypertension and
his age, he was not an
acceptable candidate at any
heart transplantation center
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Dr. Barney Clark
• He was introduced by his private doctor to Dr. Willim
DeVries• The meeting included visits to laboratories where the
Jarvik-7 was manufactured and the animal barn where
they observed calves/sheep with similar heart implants• He was given an 11-page consent form• There was no guarantee that the operation would
increase Clark’s life span, no guarantee he would regain
his independence
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Dr. Barney Clark
• The consent form stated “I recognize that if the artificial heart device fails, death or serious injury is the near certain result. I nevertheless accept the risk of substantial and serious harm, including death, implementation of the artificial heart device can be demonstrated
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Dr. Barney Clark• He signed a consent form on Nov
30, 1982 at 9:52 p.m after being
interviewed by six members of a
special heart subcommittee at
University of Utah Medical Center
• The surgery was scheduled at the
morning of Dec 2, 1982
• However, he was immediately
rushed into the operating
room because of his deteriorating
heart on Dec 1, 1982 at 10:30 p.m.
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Dr. Barney Clark
•He survived with Jarvik-7 for
112 days• A serious of complication
led to Clark’s death from
circulatory and multi-organ
collapse on March 23 at
10:02 p.m.
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Two recipients of AbiCor artificial heart
• Robert Tools, first recipient of AbiCor artificial heart was died five months after implantation, 2001
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Two recipients of AbiCor artificial heart
•Tom Christerson, second recipient of AbiCor artificial heart are still alive for more than one year
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Artificial hearts abandoned
• By the end of the ’80s, the Jarvik devices had been
implanted to sustain patients waiting for transplants• Since then, development of an improved artificial heart
has continued• Scientists continue to work on designs for an artificial
heart that could provide a realistic, permanent option for
survival• Jarvik is now working on the Jarvik 2000, a thumb-sized
heart pump
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Artificial hearts abandoned
• Universal infection
• Thromboembolism
• Total artificial heart may be better used as a bridge to transplantation
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LVAD
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Artificial heartArtificial heart