A fist-sized contraption of plastic and metal kept 63-year-old Grant Feusner alive for five weeks earlier this year, pumping blood from his chest to his brain, kidneys and muscles. Doctors had removed most of Feusner's heart, ballooned with disease and too weak to nourish his organs with oxygen and nutrients.
It wasn't the first time Feusner's doctors at the University of Maryland Medical Center had implanted such a device. Artificial hearts are designed to be used as a bridge from heart failure to heart transplant. But the handful of patients who had received them at UMMC died before a new heart became available.
For Feusner, time did not run out. A heart became available April 1, his 64th birthday — something he doesn't see as mere coincidence.
"Alone, that could have been a coincidence," Feusner said. But combined with all the other circumstances it took to get him to the hospital, through surgery and to the top of the transplant list, he sees it as more than that. "If you have faith in your life, you recognize it when you see it."
Feusner's case is the only of its kind in Maryland. Rarely does a patients' heart disease warrant a full artificial heart, rather than a similar system that assists only one side of the heart. But among that small group, Feusner is the first in the state who survived with the artificial heart long enough to undergo a successful transplant.
"It takes a special type of person to agree to go forward with a full artificial heart," said Dr. Erika Feller, Feusner's cardiologist. "He looks fabulous."
Feusner started to become concerned about his health last summer, when he had to shorten his walks on a treadmill from 45 minutes to 30 minutes, then 20 minutes, then less. He lost his breath doing everyday activities at his Reisterstown home and at work in his job designing security and surveillance systems. He had to prop his head up in order to breathe while he slept.
He began visiting doctors at the university medical center in September. Doctors there eventually diagnosed him with dilated cardiomyopathy, in which the heart becomes enlarged, its valves function poorly, and it pumps blood so poorly, vital organs essentially begin to shut down.
Whereas a healthy heart pumps out about 65 percent of the blood in its chambers with each beat, Feusner's heart efficiency was about 15 percent.
In most cases, that can be helped using what is known as a left ventricular assist device, or LVAD, a mechanical device that helps the heart pump blood to the body. But some patients' hearts are so weak, they need help from additional devices or an entirely artificial heart.
By February, Feusner's condition had worsened so much that an artificial heart became his best option given the wait for a heart transplant, Feller said.
Just over 1,000 people have received artificial hearts made by SynCardia Systems Inc., the same as Feusner's, since the FDA approved the device in 2004. Such patients make up only a handful of those who receive heart transplants each year, said Dr. John V. Conte, a professor of surgery in the division of cardiac surgery at the Johns Hopkins Medical Institutions.
There were 23 heart transplants in Maryland in 2011, all of them at University of Maryland and Johns Hopkins; 2,322 heart transplants were performed last year nationwide, according to the federal Organ Procurement and Transplantation Network.
Hopkins never has implanted an artificial heart, Conte said. The hospital abandoned its artificial heart program about four years ago because LVAD pumps have proved so effective and such a small minority of patients need artificial hearts, he said.
The surgery to implant an artificial heart is a technically challenging one, Feller said, in part because the device has to fit within the anatomy of a patient's chest cavity. Feusner's chest was kept open for three days during his surgery as doctors waited for bleeding and swelling to subside, she said.
During the five weeks he had the device inside him, he remained in the hospital attached to a washing machine-sized system that controlled the artificial heart's beat rate and pressure. Doctors called it "Big Blue" for its size and color, Feller said.
The artificial heart allowed Feusner to move up the heart transplant list. The devices are designed to last up to two years, but patients who receive them often die in just a few months. Feusner lived long enough to receive the heart of a healthy young man.
Feusner spent about 21/2 months in the hospital, first at the university medical center and then at Kernan Hospital for rehabilitation. He has been back at home for about two weeks, and only been able to stand up on his own with a walker for five days.
Though he is taking about 70 pills a day to ensure, among other things, that his body doesn't reject the heart, it's worth it, he said. His first grandchild was born during the artificial heart surgery, and he looks forward to getting to know her.
Monday afternoon as his wife, Tien, wheeled him to more doctors' offices, he vowed to become an advocate for organ donation and for personal health awareness. He also plans to reach out to the family of his heart donor, to give them the opportunity to contact him.
"You cry a little bit when you first hear about it," Feusner said. "A young man lost his life and saved mine, and perhaps others."