Hearts Of Steel
Two decades since Barney Clark's heroic act
On Thanksgiving Day 21 years ago, retired dentist Barney Clark was so ravaged by heart disease that his relatives had to hoist the very tall, very heavy 61-year-old down the stairs so he could say grace. That night, he told his wife that he wanted to donate his life for the cause of artificial heart technology. In early December, doctors implanted a device called the Jarvik-7, and for the next 112 days the world watched in awe as the man-made heart kept the blood coursing through Clark's veins and tethered his soul to his body.
Since that winter of 1982, hundreds of new Barney Clarks have allowed surgeons to cut open their chests and implant various machines in hopes of finding one that can take over when God-given hearts fail. The fantasy of a heart that could be simply swapped in to replace one gone kaput remains fairly elusive, but enormous strides have been made in technology that helps ailing hearts continue to do their job. Thanks to these devices, dozens of people who would have died months or even years ago are out mowing the lawn, watching their kids' soccer games, and--in at least one case--taking up snowboarding.
Size matters. After his historic procedure, Clark never left the hospital. The plastic pump in his chest was connected by several tubes to machinery as heavy and large as a refrigerator. Today's pioneers are implanted with devices as small as a C-size battery, connected by one small cord to wearable battery packs. "It's so easy to forget about that sometimes I'll set the pack down and walk away until the yank of the cord reminds me," says David Warner, who is part of a study testing the Jarvik 2000, a pump inserted inside the left ventricle of a weak heart to help draw blood from the lungs and push it forward through the aorta. Warner says it has given him back his life. At age 49, his heart had deteriorated so much that he couldn't walk two blocks. Today he enjoys 2-mile strolls.
In Warner's case, the device is being used as a "bridge to transplant," a way of keeping him healthy until a donor's heart becomes available. But in European studies, the same device is showing promise as a permanent solution. Indeed, one patient has lived with the implant for three years. And a study sponsored by the National Institutes of Health found that a similar device, called the HeartMate, did a better job than standard medical treatments at improving patients' well-being. Last year, the Food and Drug Administration approved its use as a permanent solution, and this year Medicare has agreed to reimburse patients who undergo the procedure.
Government approval is encouraging the development of ever newer devices. Some of the experimental designs use the same technology as magnetic levitation trains: They allow a tiny suspended rotor to channel blood throught the heart without touching another machine part, avoiding the common wear and tear due to friction. Others aim to get rid of the tube entering the body, which leaves patients vulnerable to infection. One is in the works that would be tiny enough to fit into the heart of a newborn.
But there will always be patients whose hearts are too far gone to benefit from pumping aids, and so the search continues for an actual, self-contained heart that could be transplanted into a patient. The best known "total" replacement heart, called the AbioCor, has been in the works for years. But three of the first five recipients died quickly, dimming enthusiasm for its development. Just last month, a medical group in Japan reported that it had successfully developed a wireless artificial heart. The device had been implanted into cattle, who survived and appeared to be functioning well. One of the selling points of the Japanese heart is that it contains a rechargeable battery that would allow patients to walk around without the clumsy power units. And, because there would be no break in patients' skin, they would be able to shower and bathe normally, something not possible with the current generation of pumps.
It is only a matter of time before total replacement hearts become a reality, says William DeVries, the surgeon who implanted the heart into Clark two decades ago. Meanwhile, these heart-assisting devices give patients a better shot at being around for important anniversaries. "These devices give people enormous hope and peace of mind, knowing that we have options," says Warner, whose oldest child will get married next month. "I can tell you with certainty that for people with serious heart problems, hope is the most essential thing."
This story appears in the December 1, 2003 print edition of U.S. News & World Report.