Louisville, Ky. A patient on the brink of death has received the world's first self-contained artificial heart a battery-powered device the size of a softball that runs without the need for wires, tubes or hoses sticking out of the chest.
Two surgeons from the University of Louisville implanted the titanium and plastic pump Monday during a seven-hour operation at Jewish Hospital. The hospital said the patient was "awake and responsive" Tuesday and resting comfortably. It refused to release personal details.
The patient had been expected to die within a month without the operation, and doctors said they expect the artificial heart to extend the person's life by about a month.
But the device is considered a major step toward improving patients' quality of life.
The new pump, called the AbioCor, is also a technological leap from the mechanical hearts used in the 1980s, which were attached by wires and tubes to bulky machinery outside the body. The most famous of those, the Jarvik-7, used air as a pumping device and was attached to an apparatus the size of a washing machine.
"I think it's potentially a major step forward in the artificial heart development," said Dr. David Faxon, president of the American Heart Assn.
However, he said the dream of an implantable, permanent artificial heart is not yet a reality: "This is obviously an experimental device whose long-term success has to be demonstrated."
Only about half of the 4,200 Americans on a waiting list for donor hearts received them last year; most of the rest died.
Some doctors, including Robert Higgins, chairman of cardiology at the Medical College of Virginia in Richmond, said artificial hearts are unlikely to replace donor hearts.
"A donor heart in a good transplant can last 15 to 30 years," he said. "It's going to be hard to replace that with a machine."
The experimental heart, made by Abiomed Inc. of Danvers, Mass., was implanted by Drs. Laman Gray and Robert Dowling, one of five surgical teams across the country trained to use the device in human experiments.
The AbioCor has a two-pound pumping unit, and electronic controls that adjust the pumping speed based on the body's needs. It is powered by a small battery pack worn outside the body that transmits current through the skin.
The heart also has a rechargeable internal battery, about the size of a pager, that can work on its own for about 30 minutes long enough for a patient to remove the battery pack and take a shower, for example.
The hope is that such mechanisms will one day allow recipients to lead a relatively normal life, said John Watson of the National Heart Lung and Blood Institute, which has given $20 million toward research into self-contained artificial hearts.
"They are able to do just about anything they like to do up through, what I call, moderate exercise," Watson said.
David M. Lederman, Abiomed president and chief executive, said in April that the company had received federal approval to perform at least five human trials with the artificial heart. The patient in Louisville is the first to receive the device.
Patients selected for the trial must be suffering from a chronic, progressive heart disease expected to result in death within 30 days. They have to be ineligible for a human heart transplant. Most of the patients are so ill that they cannot walk or perform the daily routine of life.
The goal of the experiments with the artificial heart is to double the life span of these patients to 60 days, Lederman said earlier this year.
"Every patient will probably die on the AbioCor," he said. "We need to understand that with this new technology, we may have failures."
The first recipient of an artificial heart, Barney Clark, a Seattle-area dentist, lived 112 days after receiving a Jarvik-7 in 1982. William Schroeder of Jasper, Ind., lived longest with a complete artificial heart 620 days before he died in 1986.