Surgery Halts Heart Recipient’s Bleeding
Surgeons took retired railroad engineer Jack C. Burcham, the world’s newest artificial heart recipient, back into surgery for two hours Monday and stopped persistent internal bleeding from stitches used to implant his man-made heart.
Dr. William C. DeVries, who operated on Burcham Monday, has performed four of the world’s five permanent artificial heart implants. Each of his four patients has suffered some form of bleeding, and the other three also underwent additional surgery to correct it.
“It’s very distressing,” said Dr. Allan M. Lansing, chief clinical spokesman for Humana Heart Institute International.
Seeped From Stitches
In Burcham’s case, blood had seeped from stitches that were strained during Sunday’s struggle to implant the Jarvik-7 pump in Burcham’s chest cavity, which was smaller than doctors had expected.
Blood had leaked through sutures that bind the aorta to the man-made fabric that is connected to the heart, Lansing said. The pumping of the heart “was just too much” for the stitches, which already had been strained by Sunday’s operation, he said.
“Every little needle hole showed a tiny little leak through it,” Lansing said. Surgeons stopped the bleeding by using small pieces of Teflon felt to cover each stitch.
William J. Schroeder, 53, of Jasper, Ind., was rushed back into surgery six hours after his implant on Nov. 25 to correct bleeding that doctors said was caused by a similar problem. But, in Schroeder’s case, scar tissue from a previous heart operation also caused excessive bleeding, his doctors said.
Pressure on Lungs
Murray P. Haydon, 58, of Louisville, received his heart Feb. 17 and was back in surgery 13 days later to correct bleeding apparently caused by the removal of a monitoring line to his mechanical heart. The accumulated blood, and its pressure on his lungs, may be responsible for current breathing difficulties, which have kept him on a respirator and in intensive care, doctors have said.
Barney Clark, the first recipient, who lived 112 days with the heart implanted on Dec. 2, 1982, did not suffer internal bleeding but did have chronic nosebleeds that doctors say were related to a high dosage of blood-thinning drugs.
Leif Stenberg, 53, the fifth artificial heart recipient, was reported doing well at a hospital in Sweden.
Lansing described Burcham’s bleeding as a setback but he said that the operation Monday was not necessarily a roadblock to recovery. Burcham, 62, of Le Roy, Ill., was taken back to the coronary care unit, where he remained in critical but stable condition.
Massive Transfusions
Burcham lost more than 10 quarts of blood during the operation, roughly double the amount of blood in an adult body, and he needed massive transfusions. Although the bleeding itself was not life-threatening, it was cause for concern, Lansing said.
The blood was accumulating in Burcham’s chest faster than it could be evacuated by four drainage tubes, doctors said. It was putting pressure on the patient’s lungs and heightened the risk of infection.
DeVries, who plans at least three additional heart implants, has put all of his patients on anti-coagulants--medications that tend to keep blood from clotting and thus reduce the chance of a stroke.
