Three hearts, second chance at life for Gilbert woman

Friday, September 21, 2007

SCOTTSDALE, Ariz. – In a period of just 13 days, a 56-year-old Gilbert, Ariz., woman has felt the beating of three different hearts – all within her own chest: First, her own, failing heart. Then, in what is considered groundbreaking in the Valley, an artificial heart. And, on day 13, a donor heart.

She is the first Valley patient to have been implanted with an artificial heart, a mechanical device that replaced her own heart – a bold, yet necessary intervention intended to keep her alive until a suitable donor heart would be available and she could be transplanted.

The device is typically used when both sides of the patient's heart are failing and when other treatments have been exhausted. Such was the case with the patient, who has suffered from congestive heart failure and was running out of options.

Surgery to implant the device took place at Mayo Clinic Hospital in northeast Phoenix on Wednesday, Aug. 22, 2007. Leading the surgical team was Dr. Francisco Arabia, Mayo Clinic's heart transplant program director, recognized by peers as one of the top surgeons in the world to implant the artificial heart.

The patient's new "heart," made of polyurethane, is acclaimed as an engineering marvel, yet is basically simple in design. Two ventricles, held together by Velcro, provide for inflow and outflow of blood. The artificial heart is attached to an external power source that pumps the blood, typically up to 9.5 liters per minute. The pneumatic, biventricular system, manufactured by Tucson-based SynCardia Systems, Inc., is formally called the CardioWest temporary Total Artificial Heart (TAH-t). It is a modern-day version of the earlier Jarvik-7 artificial heart of the 1980s. The TAH-t earned FDA approval in 2004.

During the procedure, the patient's own damaged heart was removed, she was put on the heart-lung machine and the artificial heart was implanted, Blood began flowing immediately, and within a week, she was out of intensive care and walking – with her power station in tow. Dubbed by many as "Big Blue," the power station supplies air pressure to keep the artificial heart running.

Then the waiting began for a suitable donor heart. That waiting ended sooner than many expected, on Sept. 4. Dr. Arabia, who had implanted her artificial heart, removed it and implanted her new heart, from an unnamed donor.

The Mayo Clinic patient is considered a pioneer, in that outside of Tucson, Ariz., she is the first in the Southwest and on the west coast to have been implanted with the TAH-t. The surgery is considered groundbreaking, because unlike a Ventricular Assist Device (VAD), which is implanted next to the existing weakened human heart to assist with pumping, the patient's own heart is removed.

The stark reality is that once the device is implanted, the patient is actually "flat-lining," a visual that can be startling, considering that patients are able to sit up and even walk the halls of the hospital. But the amount of blood pumping through both ventricles is considered the highest of all mechanical heart devices.

Hers has been a complex case – not a matter of simply exchanging her damaged human heart for one made of polyurethane. Because of the extent of her heart damage and her weakened condition, she was outfitted first with a catheter and balloon pump, with the plan being that she would next receive a VAD.

In her case, however, Mayo physicians ascertained that her condition was grave enough that they would skip the VAD stage and move directly to the artificial heart as a bridge to a transplant.

The patient, a wife, grandmother and long-term employee of a local telecommunications company, said she had faith in her medical team and didn't want to consider the "alternative" when presented with the artificial heart option. "I was going to go for it. I have a new grandbaby to think about," she affirmed.

About Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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