Faculty Collaboration Database

Clinical use of the total artificial heart. N Engl J Med 1984 Feb 02;310(5):273-8

Date

02/02/1984

Pubmed ID

6690950

DOI

10.1056/NEJM198402023100501

Scopus ID

2-s2.0-0021335346 (requires institutional sign-in at Scopus site)   251 Citations

Abstract

We report here our first experience with the use of a total artificial heart in a human being. The heart was developed at the University of Utah, and the patient was a 61-year-old man with chronic congestive heart failure due to primary cardiomyopathy, who also had chronic obstructive pulmonary disease. Except for dysfunction of the prosthetic mitral valve, which required replacement of the left-heart prosthesis on the 13th postoperative day, the artificial heart functioned well for the entire postoperative course of 112 days. The mean blood pressure was 84 +/- 8 mm Hg, and cardiac output was generally maintained at 6.7 +/- 0.8 liters per minute for the right heart and 7.5 +/- 0.8 for the left, resulting in postoperative diuresis and relief of congestive failure. The postoperative course was complicated by recurrent pulmonary insufficiency, several episodes of acute renal failure, episodes of fever of unidentified cause (necessitating multiple courses of antibiotics), hemorrhagic complications of anticoagulation, and one generalized seizure of uncertain cause. On the 92nd postoperative day, the patient had diarrhea and vomiting, leading to aspiration pneumonia and sepsis. Death occurred on the 112th day, preceded by progressive renal failure and refractory hypotension, despite maintenance of cardiac output. Autopsy revealed extensive pseudomembranous colitis, acute tubular necrosis, peritoneal and pleural effusion, centrilobular emphysema, and chronic bronchitis with fibrosis and bronchiectasis. The artificial heart system was intact and uninvolved by thrombosis or infectious processes. This experience should encourage further clinical trials with the artificial heart, but we emphasize that the procedure is still highly experimental. Further experience, development, and discussion will be required before more general application of the device can be recommended.

Author List

DeVries WC, Anderson JL, Joyce LD, Anderson FL, Hammond EH, Jarvik RK, Kolff WJ

MESH terms used to index this publication - Major topics in bold

Blood Pressure
Cardiac Output
Cardiomyopathy, Dilated
Electrocardiography
Heart Failure
Heart, Artificial
Humans
Lung Diseases, Obstructive
Male
Methods
Middle Aged
Postoperative Complications
Postoperative Period
Prosthesis Design
Time Factors