Infections Limit Use of Jarvik Heart, Study Finds

The Jarvik-7 artificial heart probably will never be a satisfactory permanent implant because the infections it causes are unavoidable, researchers concluded Thursday.

Doctors familiar with the air-driven pump called for a 30-day limit on using the Jarvik as a bridge to a human heart transplant, and one physician warned that future attempts at permanent transplantation “will only serve to further document the magnitude of the complications.”

But Dr. William DeVries, the only surgeon authorized to perform permanent transplants in the United States, said he is confident that the Jarvik’s problems can be overcome and is seeking a candidate for his fifth permanent transplant.

Only four patients have had permanent Jarvik transplants, beginning with Dr. Barney Clark of Des Moines, Wash., who received the device Dec. 2, 1982, and died 112 days later. The other patients also died.

Since the last death, the device, made by Symbion Inc., of Salt Lake City, has been marketed only as a temporary bridge to a human transplant and has been used on 84 patients.

“We really don’t expect it to be used as a permanent device anymore,” Symbion marketing director David Snider said.

In a special issue of the Journal of the American Medical Assn., Dr. Calvin Kunin of Ohio State University noted that in addition to well-publicized clotting problems, infection invariably developed in long-term Jarvik-7 patients.

“It was impossible to eradicate the infectious process despite intensive therapy with modern antibiotics,” Kunin and his colleagues concluded. “These problems would be difficult, and likely impossible, to correct.”

In a separate review, DeVries and his Humana colleagues acknowledged the infection problems and admitted that “the quality of life that was hoped for by the patient or his family may not have been what was ultimately obtained.”

But DeVries said he hoped advances in patient care, as well as modifications in the Jarvik-7, would reduce the chance of infection. One possibility is embedding antibiotics in the heart’s material, he said.

“I think what we have here is the Model T Ford of artificial hearts, and each step is going to be a bit different,” he said.