Sept. 8, 2000 -- Six-weeks after having a Jarvik 2000 battery-operated heart pump implanted, a 61-year-old man with advanced heart failure is walking and sleeping like a new man, says a team of surgeons and cardiologists. The man, the first patient to receive a permanent implant of the new Jarvik heart, improved his heart stress test results by 75%.
Thus far, the team at John Radcliffe Hospital in Oxford, England, has completed permanent implants of the Jarvik 2000 in two patients, says O. Howard Frazier, MD, professor of surgery at the Texas Heart Institute in Houston. Frazier is a co-author of an article about the implant in the Sept. 9 issue of TheLancet, and he was one of the surgeons who implanted the first patient during surgery on June 20 in England.
The Jarvik 2000, developed by Robert Jarvik, MD, is a thumb-sized pump that is implanted directly into the heart wall. Frazier says the trial of permanent implants is being conducted in the U.K. because "the National Health Service [there] prohibits transplants after age 60, so England is an area where you can easily find candidates for this procedure." Frazier says the first patient operated on had very severe heart failure with an enlarged heart.
Frazier also completed the first successful temporary implantation of the device in a U.S. patient just this April in Houston. That surgery was done to buy time for a woman who was waiting for a transplant, which is another strong use of the implant.
Already, a second person in the U.S. has benefited from the surgery. David Lancaster, 31, of Houston had a Jarvik 2000 implanted by Frazier at St. Luke's Episcopal Hospital. Before the implant, "my heart took up 75% of my chest but was working at only 20% efficiency," he says.
"The Jarvik gave me the good recovery I needed to be ready for my heart transplant," Lancaster tells WebMD. He received a donor heart on Aug 4. "I was strong enough that I was able to be discharged on Aug. 18," he says. Now, says Lancaster, "I am walking about 20 minutes a day, and doing housework ... the Jarvik gave me a chance to have a life."
"Implanting this device is much easier than the surgery required for the old pulsatile pumps, and there is much less blood loss," Frazier says. He says that the simplicity of the implant "makes it easier to do in England because they really don't have a lot of experience there with implants, so this is an ideal one to use in that setting."
When the device is permanently implanted, an external power supply is attached to the head directly behind the ear. This attaches to a portable controller and battery, which can be worn on the belt. Frazier says, "Jarvik has long experience with the ear pedestal that is fixed to the head. It appears to be very resistant to infection, so that's one of the advantages."
Frazier says the device is among the most patient friendly of the heart pumps because "it's very quiet. Patients don't even hear it, and it's easy to forget about it. One patient said the only difference she noticed was that she wasn't short of breath."
William Smith, PhD, a researcher in the department of biomedical engineering at the Lerner Research Institute of the Cleveland Clinic Foundation, says that there are "about 10 to 12 devices that are in development or in clinical trials now" of which the Jarvik 2000 is one. "But Jarvik is actually coming fairly late to the field because another manufacturer, MicroMed, already has over 50 cases with their device, which is also a rotary impeller design," he explains.
Smith says that the goal of most researchers in the field "is over the next three to five years to get maybe a dozen devices into clinical trials so that someday a surgeon will have as many as 10 different devices that will be options suited to individual patient needs."