With Each Operation, Artificial Hearts Show More Promise

PHOTO: Grant Feusner holds his granddaughter, Jade.

Grant Feusner, a 64-year-old security systems engineer, started having an odd constellation of health symptoms a year ago.

"I had difficulty breathing, a dry mouth, couldn't sleep, and had difficulties performing my job," said Feusner, of Maryland. "My quality of life was pretty good up until that point."

Feusner went to go see a cardiologist at the University of Maryland, where, after a battery of tests, he was diagnosed with heart failure. Worse, doctors told him that his condition could not be managed by drugs alone.

"I wasn't doing very well with medication adjustments," said Feusner. "I responded well in the short-term, but my [body] was pushing back."

Even after doctors implanted a defibrillator into his heart to shock it back into rhythm when necessary, his heart failure continued to worsen.

Feusner needed a new heart.

Not long ago, patients like Feusner would have faced a grim prognosis, as there would have been few options available to sustain him until a donor heart became available. But that may be changing.

On June 21, physicians at Brigham and Women's Hospital in Boston announced that they had performed the first successful artificial heart transplant in New England for a patient who, like Feusner, had advanced heart failure.

"It's a regional milestone," said Dr. Gregory Couper, surgical director of the heart transplant program at Brigham and Women's. "This is the first implantation of an artificial heart in a patient needing a heart transplant in New England."

Although this is the first transplant in New England, other artificial heart transplants have already been performed around the United States and internationally. In fact, artificial hearts are being manufactured by a few companies, one of which is testing their device at 30 sites across the country.

More than 5 million people in the United States currently have heart failure. In heart failure, the heart muscles weaken such that the heart is unable to pump a sufficient amount of blood through the body. If the heart failure is left untreated, then other organs, including the kidneys, begin to fail.

Physicians will first attempt to manage heart failure patients with medications that help get rid of excess fluid in the body while also controlling blood pressure. For the 50,000 to 100,000 patients with advanced heart failure who cannot be treated with medications, a device known as the left ventricular assist device (LVAD) may be helpful. LVADs are devices that replace the function of the failing heart, and artificially pump blood throughout the body's circulatory system.

But in some cases even LVADs may not be effective in helping heart function. That is where artificial hearts come into play. The artificial heart acts as a bridge therapy -- a temporary measure until a patient can get off the organ donor waiting list and receive a heart transplant. About 2,000 heart transplants are performed in the U.S. each year, although thousands more -- if enough donors were available -- could potentially benefit from them.

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