Era of artificial hearts is just a beat away

700 artificial hearts the size of a golf ball have been transplanted around the world, as well as in Israel for the first time.

THE NEW, tiny HeartWare artifical heart. (photo credit: Courtesy)
THE NEW, tiny HeartWare artifical heart.
(photo credit: Courtesy)
The era that the late South African heart transplant pioneer Dr. Christiaan Barnard dreamed of is coming much closer: Forty-three years after he performed the first human heart transplant, 700 artificial hearts the size of a golf ball have been transplanted around the world, as well as in Israel for the first time.
Although the US-made HeartWare device still has to be powered by a battery connected by wires via the abdomen and worn on the belt like a beeper, it won’t be long before the US company presents a model that can be recharged through the chest and can offer a permanent solution to people with diseased hearts.
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Prof. Dan Aravot, chief of cardiothoracic surgery at Carmel Medical Center in Haifa, recently implanted the Heart- Ware device into the chest of a 74-year-old kibbutznik named “Ronen” (he asked that his identity not be revealed), who suffered from acute cardioinsufficiency and was not a candidate for a heart transplant because he is nine years older than the maximum age for that procedure.
The $115,000 device – from a new generation of artificial hearts and the most advanced available in the world – was supplied by the hospital, but it hopes to be reimbursed by the man’s health fund or the Health Ministry, as a lessadvanced artificial heart is already included in the basket of health services. A human-heart transplant costs somewhat less than the artificial heart implant if the salaries of surgeons and hospital costs are included.
Aravot told The Jerusalem Post on Sunday that the 140- gram device, inserted during a five-hour operation, allows the patient to get around independently. It has a capacity of 50 cubic centimeters of blood at once and does not destroy the blood cells as it pumps.
There are patients abroad who have lived with these little artificial hearts in their chests for as long as three years without suffering equipment breakdowns. The early artificial hearts required patients to be wheeled around with a refrigerator-sized pump and electricity source that was terribly unwieldy.
Ronen’s own heart was not removed, said Aravot, as it functions at about 15 percent capacity. It can thus can assist the titanium-alloy device, or the artificial pump can work alone. Ronen is now in his hospital bed reading newspapers and chatting with visitors.
Aravot said that when the HeartWare device can be charged from outside without being connected to wires, “it will be a real breakthrough.”
In the meantime, only patients who are not candidates for a human heart because of their desperate condition or age are being considered for the artificial heart implant, he added.
There are 120 Israelis waiting for a heart transplant, and only 15 lucky ones get a donated organ each year.
Ronen – the oldest artificial heart recipient in Israel and one of the oldest in the world to get the HeartWare – received it on his birthday, just after Rosh Hashana. While the patient had doubts about being a pioneer, he finally agreed because his coronary insufficiency had become so severe that he did not respond to any medications.
Dr. Opher Amir, head of the coronary insufficiency unit at the Haifa hospital, said that the patient had a pacemaker inserted after his last heart attack, but his condition did not improve. Ronen said that in the last year, he suffered shortness-of-breath attacks after walking just a few steps and was unable to function.
He consulted with Carmel’s cardiology department director Prof. Basil Lewis, Amir and Aravot, and realized that the artificial heart was the only thing that could save him. He met with two people who had previously undergone artificial heart implants and saw they functioned well.
The new model pumps blood from the left ventricle in a centrifugal flow using strong magnets set inside the device.
Then it injects the blood directly into the aorta at 2,700 revolutions per minute.
The advantage of the new model, said Aravot, is that it preserves the elements of the blood so they don’t break down during the pushing and sucking action. The red cells remain whole – a factor critical to treatment and recovery.