Completely implantable total artificial hearts: Status at the Texas Heart Institute
Since the 1950s, the prospects for a mechanical device to replace the failing heart have intrigued clinicians, engineers, and the general public. Considerable effort has gone into the design and development of complex (and often impractical) artificial hearts.
The first artificial heart was implanted by Cooley in 1969, when the life of a 47-year-old man was sustained by the mechanical device for 64 hours while he was awaiting cardiac transplantation. Since that initial experience, several investigators have used a variety of implantable devices as bridges to transplant. In addition, the pioneering research of Kolff, Jarvik, and associates preceded the experimental clinical use of their device by DeVries as a permanent replacement for the diseased heart. These experiences have demonstrated the potential of the total artificial heart. At the same time, however, the limitations of the existing technology have been revealed, especially in the areas of anatomic compatibility (device fit) and biomaterials (thrombogenicity). These problems are being addressed by various investigative teams throughout the world.
The United Network for Organ Sharing has estimated that each year 50,000 patients are in need of cardiac replacements. Because of the limited availability of donor hearts (about 1800 per year), a large number of these patients might benefit from a permanent total artificial heart. Within the next decade, we may see the initiation of clinical trials with a new “generation” of permanent artificial hearts and left ventricular assist devices.
The initial goal of total artificial heart developers was to find a permanent replacement for the natural heart. As early as 1958, Akutsu and Kolff  reported total replacement of the natural heart in a dog, and in 1962, Akutsu , reported the first dog to survive longer than 24 hours with a sac-type polyurethane total arti- ficial heart. Since then, research has yielded several artificial hearts and circulatory assist devices that may ultimately prove safe and reliable, yet some limitations must be overcome before a permanently implantable device is realized. Our current experiences are bringing us closer to that goal.
KeywordsImplantable Device Artificial Heart Donor Heart Tissue Valve Natural Heart
Unable to display preview. Download preview PDF.
- 1.Akutsu T, Kolff WJ (1958) Permanent substitutes for valves and hearts. ASAIO Trans 4:230–235Google Scholar
- 4.Cooley DA, Akutsu T, Norman JC, Serrato MA, Frazier OH (1981) Total artificial heart in two-staged cardiac transplantation. Cardiovascular Diseases, Bulletin of the Texas Heart Institute 8:305–319Google Scholar
- 5.Joyce LD, Johnson KE, Cabrol C, Griffith BP, Copeland JG, DeVries WC, Keon WJ, Wolner E, Frazier OH, Bucherl ES, Semb B, Akalin H, Aris A, Carmichael MJ, Cooley D, Dembitsky W, English T, Halbrook H, Hetzer R, Herbert Y, Keon WJ, Loisance D, Noon G, Pennington G, Peterson A, Phillips SJ, Pierce WS, Unger F, Pifarre R, Tector A (1988) Nine year experience with the clinical use of total artificial hearts as cardiac support devices. ASAIO Trans 34:703–707PubMedGoogle Scholar