Heart Transplant Fails; Jarvik-7 Implanted in 1st California Patient
In the first use of an artificial heart in California, a team of surgeons in San Diego has implanted a Jarvik-7 mechanical heart in an Escondido man whose transplanted human heart had failed.
Randy Dunlap, 34, received the device at Sharp Memorial Hospital on Tuesday after his transplanted heart failed to support his circulation. Hospital officials said the device is to serve as a temporary “bridge” to keep Dunlap alive until another human heart can be found.
Dunlap had been suffering from cardiomyopathy, a chronic degenerative heart condition that ran in his family. He had received a human heart transplant late Monday night; when the heart failed, the hospital was unable to secure a second human heart.
The Jarvik heart, initially intended for permanent use, has been used since August, 1985, as a bridge in nearly 60 patients worldwide. Sharp Memorial Hospital in December became the 15th medical center in the United States to receive federal government approval to implant the experimental device.
Other centers that have used the heart as a bridge are located in Pittsburgh, Minneapolis, Milwaukee, Tucson, Houston and Gainesville, Fla.
Steps Failed
The three-hour operation in San Diego occurred after Dunlap’s surgeons tried to support the faltering human heart with so-called ventricular assist devices and a balloon pump. When those steps failed, they implanted the artificial heart, hospital spokeswoman Cindy Cohagen said.
Dunlap, a backhoe operator who had been unable to work because of his heart condition, was reported in critical but stable condition Thursday.
Gary Cole, a vice president of Symbion Inc. in Salt Lake City, said that as of the beginning of this month, 58 patients had benefited from the use of the company’s artificial heart as a bridge to a transplant. Forty-three of those patients eventually received human hearts, 11 died before transplantation and four were awaiting a transplant.
He said the recipients’ median duration on the polyurethane heart was nine days. One woman, who received two artificial hearts because two transplants failed, spent 243 days on the artificial devices.
The Jarvik heart, named after one of its designers, Robert Jarvik, was first implanted in a human in 1982. At the time, it was intended as a permanent replacement. The patient, Barney Clark, survived 112 days.
Permanent Artificial Hearts
In 1984 and 1985, three more patients received permanent artificial hearts. The longest survivor lasted 620 days. Because the patients were plagued by blood clots, infections and other complications, surgeons turned to using the heart as a temporary bridge.
Dr. William DeVries, the Utah surgeon who pioneered the device, remains the only physician with federal approval to implant the permanent artificial heart. However, he has not done the operation since 1985.
Donna Hazel, a spokeswoman for the Louisville, Ky., hospital where DeVries now works, insisted Thursday that DeVries has not written off the possibility of implanting additional permanent artificial hearts. She said he is still waiting for “as strong a patient as possible.”
