Hope For The Year 2000 – The Jarvik 2000 Heart

Robert Jarvik, the New York based inventor of Jarvik 2000 heart was a happy man this year. The thumb-sized intraventricular assist device was permanently implanted into a 61 years old man with end stage heart failure in June 2000 by Stephen Westby, MD and colleagues from the John Radcliff Hospital in Oxford, UK .It was part of a prospective clinical trial that eventually will enrol 6 patients with cardiomyopathy.

After 6 weeks of use, the researchers found that the Jarvik 2000 sustained the patient’s circulation and improved exercise tolerance. It also improved cardiac and end- organ function thereby resolving this symptom of heart failure. There was no significant haemolysis or device related complications. The 14 hour operation involved implanting the titanium impeller pump in the patient’s left ventricle. The pump is powered by a cable that passes from the device to the chest, then through the neck to a pedestal screwed into the skull behind the ear. The pedestal based on cochlear implant technology transmits the cable to an external portable controller and battery, both of which are worn on the patient’s belt. The controller has a single dial enabling the patient to regulate the impeller speed according to activity level.

According to Westby and his colleagues (as reported in the lancet, September 9, 2000), given the shortage of transplant donors, the prospect of permanent mechanical circulatory support for the increasing number of patients with end-stage heart- failure was appealing. They also added that the device seemed to be suitable for permanent use, bridge to transplant or bridge to recovery. 

LVAD Successful Implant Could Remove Necessity For Heart Transplant

Another success story with a left ventricular assist device was noted by surgeons at the University of Pittsburgh (PA) Medical Centre (UPMC) when they implanted it into a 52 year old man with severe coronary artery diseases. The implant was necessitated when he could not be weaned from the heart lung machine and designed to serve as a bridge to transplant. However, approximately 4 weeks after receiving the device the patient began to make “steady improvement”. The LVAD was surgically removed 2 weeks later and the patient was taken off the heart transplant waiting list. The patient was well enough to be discharged after another 2 weeks. Robert Kormos, MD, director of the artificial heart and heart transplant programme at UPMC said that this case demonstrated that patients with ischaemic heart diseases or chronic heart disease could recover on an LVAD and not need a transplant, He felt that if LVADs were put into wider practice, there would be fewer patients competing for the limited number of donor organs. This particular case is a first because although patients with non- ischaemic heart diseases have recovered after using an LVAD, this is the first time a patient with ischaemic cardiovascular disease  has been reported to have recovered. This LVAD was developed by Thoratic Laboratories.