Texas Man Pioneers Use of Beatless Heart, the Wave of the Future

Doctors at Texas Heart Institute developed artificial device that has no pulse.

June 14, 2011, 1:56 PM

June 15, 2011— -- Craig Lewis, a 55-year-old Texas man who was about 12 hours away from death, became the first human to receive what doctors are calling the "beatless heart."

The device -- two ventricular assist devices intricately tied together, replacing his entire heart -- was developed by Drs. Billy Cohn and O.H. "Bud" Frazier at the Texas Heart Institute in Houston.

They say this new machine, which whirls instead of pulses, is more reliable and could replace existing artificial hearts, which wear out and can cause clotting and strokes.

"Every animal created has a pulsitile heart, and to minic that was the natural way to proceed," said Cohn. "But to make something that actually can beat 100,000 times a day, 35 million times a year, a man-made device has to perform with that kind of endurance."

"A car can, but you change the oil and the spark plugs and do the maintenance and they go and go," he said. "These pulsitating hearts work only a year or two, then fall apart."

Older devices would have also been too large to place in women's smaller bodies. The new beatless heart is "self-contained, smaller and a more durable device," said Cohn.

Lewis, in the advanced stages of cardiac amyloidosis, which causes the organs to fail as the body accumulates abnormal proteins, had been in a coma-like state. He died last March from underlying disease, five weeks after receiving the beatless heart.

But doctors said that the heart worked perfectly. Lewis was able to sit up and talk to his family before his kidneys and liver eroded. The family ultimately chose to turn off the heart device to allow him to die "humanely," said Cohn.

The first "beatless" heart experiments were done on a calf named Abigail, and later on 38 calves, whose hearts were removed and replaced with two axial-flow pumps.

"If you listened to [Abigail's] chest with a stethoscope, you wouldn't hear a heartbeat," said Cohn. "If you examined her arteries, there's no pulse. If you hooked her up to an EKG, she'd be flat-lined.

"By every metric we have to analyze patients, she's not living," he said. "But here you can see she's a vigorous, happy, playful calf licking my hand."

In March, when doctors felt confident the artificial heart would also work in humans, they were approached by Craig Lewis' wife, Linda.

Hospital officials said she was "too emotional" to talk to ABCNews.com, but in another interview earlier this week, she said that her husband would have appreciated the doctors' invention, fashioned from Dacron, fiberglass and silicone.

Lewis had worked for the city of Houston, helping to maintain the city's vast system of wastewater pumps, and in his spare time, he "piddled around" with woodworking and metalsmithing, Linda Lewis told NPR.

His widow confirmed her husband lived, at least for a time, without a pulse. "I listened, and it was a hum, which was amazing," she said.

"He wanted to live, and we didn't want to lose him," said Lewis. "You never know how much time you have, but it was worth it."

Until now, those with full heart failure have had only had two options: a first-generation artificial heart that had limitations, or a heart transplant. But the wait for a new heart can be long, if one becomes available at all. More than 100,000 Americans are on a list for about 2,200 hearts a year.

No Pulse, No Pledge of Allegiance

The new machine relies on two simple whirling rotors, spinning blood throughout the body in a continuous flow, addressing previous problems with clotting, thrombosis and bleeding.

"I think it's fascinating," said Dr. Jay Pal, assistant professor of cardiothoracic surgery at the University of Texas Health Science Center in San Antonio.

Left ventricular assist devices, like the one that keeps alive former Vice President Dick Cheney, only help those with failure of the left side of the heart. This device, essentially two designed to accommodate both sides, can help those with right-side failure or both.

Lewis had not been a candidate for an assist pump because his left ventricle was too badly damaged by disease, and his right ventricle had also failed.

"It certainly provides more options for people who are living with advanced heart failure, and results like these show a lot of promise and move the field forward," said Pal.

Dr. Abel DeAnda, chief of cardiothoracic surgery at Bellevue Hospital Center in New York City, agrees. "This would be the wave of the future, in my opinion, the logical next step in this technology."

He said the dual rotors make the beatless heart "less mechanical with fewer parts that can fail.

"These artificial hearts will be more efficient and less costly and more successful devices -- what we have been looking for," said DeAnda. "For the number of patients who potentially need this, we have eliminated the downsides."

But the psychological aspect of the beatless heart may be its biggest drawback, even though the body doesn't seem to need a pulse.

"Who knows," said Cohn. "Where will you put your hand when you say the Pledge of Allegiance? But there is a real shortage of donor organs and 300,000 people with heart disease die each year.

"Really, only the most fortunate patients have the opportunity to get a transplant," he said. "If you had something you can take off the shelf and sew into the body with the heart that fails, you can provide hope for hundreds of thousands of patients."

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