Doctors Promote Experimental Heart Pump

HOUSTON (AP) _ Doctors at the Texas Heart Institute hope the success they've had with sending patients home after they received an experimental heart pump will result in a dependable alternative to

Monday, August 18th 2003, 12:00 am

By: News On 6

HOUSTON (AP) _ Doctors at the Texas Heart Institute hope the success they've had with sending patients home after they received an experimental heart pump will result in a dependable alternative to transplants.

Physicians at the institute, based at St. Luke's Episcopal Hospital, recently made their case for the benefits of the Jarvik 2000 heart pump with the help of Richard Brown, who received the device in April and was able to go home in June. He was one of the first heart pump patients in the country to be allowed to go home.

``I feel like I'm a blessed man,'' said Brown, 58, who was stricken with congestive heart failure after developing a virus in February. ``Since I've gotten the pump, I feel just about as well as I did before I got really sick.''

The heart pump, which is about the size of a C-cell battery, is part of a federally approved study to evaluate it as a bridge to transplantation. But Dr. O.H. Frazier, chief of cardiopulmonary transplantation for the institute, believes the device can be an alternative to transplants for patients whose health has not deteriorated too seriously. Only around 2,300 donor hearts are available each year and about 4,000 people are on the national patient waiting list.

``We hope this technology will replace transplants for many of these patients. We've always looked at it (as an artificial heart) but it's a different type,'' he said.

Since the heart institute became the first place to begin a clinical trial of the device, the pump has been implanted in 32 of its patients. Since April, three of those individuals, including Brown, have been able to go home while they await a heart transplant.

``It's something of a milestone to have a patient leave a hospital and carry on a fairly normal life,'' said Dr. Denton Cooley, the heart surgeon who founded the institute in 1962. ``Seeing these results indicates there may be a time when these devices will be a permanent transplant.''

Cooley said comparing it with similar devices, the Jarvik 2000 shows the most promise.

Frazier said he even prefers using the Jarvik over the HeartMate, a heart pump he helped pioneer at the institute.

The Jarvik ``has a greater potential for (patient) recovery, it doesn't compete against the heart but gently takes over the workload,'' he said.

The Jarvik is one of several newer heart pumps that are currently being tested which are smaller, not as prone to causing infection and can last longer than the first generation of these devices, like the HeartMate, said Dr. Joseph DeRose Jr., a cardiac surgeon at St. Luke's-Roosevelt Hospital Center and an assistant professor of surgery at Columbia University College of Physicians and Surgeons in New York City.

``As the technology develops we will find the perfect device and it will be the standard therapy (for heart disease). That's many decades down the road,'' he said. ``This is a critical step forward in moving in that direction.''

Richard Daly, a cardiac surgeon at the Mayo Clinic in Rochester, Minn., said newer heart pumps like the Jarvik represent ``a quantum leap'' in the technology.

``In the big picture we are all very excited about this,'' he said. ``We are all hopeful these new pumps will provide a better way of supporting patients than the older pumps with fewer complications and more durability.''

The device, made of titanium and steel, is a valveless, electrically powered pump that fits directly into the heart's left ventricle and continuously pushes blood throughout the body.

A small cable exits the body through the abdominal wall and connects to a small battery and controller. The device was created by Dr. Robert Jarvik, who also invented the first permanently implantable artificial heart.

Brown, who's preparing to retire from his job in Houston as a maintenance electrician for the U.S. Postal Service, said he's still not used to carrying the battery _ plus a spare _ and the controller and other equipment everywhere he goes.

``Sometimes I walk off without the batteries,'' said Brown, who sought medical help after noticing that simply climbing a set of stairs at work left him out of breath. ``It changed my life ... it brought me back to the point I was before. I'm not in a hospital bed. I'm still alive.''

Brown now spends his mornings walking, riding a stationary bike and lifting weights.

Frazier said the heart pump's many advantages _ its small size, less invasive surgery to install it _ make it a better option than transplants for many patients.

``The problems now aren't scientific. This pump works beautifully,'' he said. ``The problem is regulatory. I'm convinced this could have an enormous impact. It could do this right now. It's just dealing with these regulatory issues.''

Frazier said he's talked with Jarvik, who is preparing to present a proposal to the Food and Drug Administration for a study to look at the heart pump as a permanent support device.