The day Utah surgeons implanted the first artificial heart into retired Seattle dentist Barney Clark, the future changed for Marian Walker, Randy Case, Michael Cross and Reid Clark.
They just didn't know it.Friday, 17 years after Clark's record-making surgery, they gathered at LDS Hospital in Salt Lake City to meet Clark's widow, Una Loy Clark Farrer. They wanted to show Farrer her husband's technological legacy. And doctors also offered a peek into the future of heart technology.
Each of them lives, quite simply, because of advances made in artificial heart and assistive-device technology.
Clark survived 112 days on the artificial heart. After his death, doctors scrapped plans to use it as a permanent heart replacement and decided it would be, instead, a bridge to transplant, keeping patients alive until a human heart was available.
It has done that. Al Marsden of Boise lived for 132 days on the artificial heart before receiving a human heart. And since then, technology has evolved from massive to portable, with promises of even more smaller technology.
Barney's widow couldn't be more pleased.
"Barney knew he wasn't going to live long," she said. "But he couldn't live with himself if he didn't try it. He wanted to do this so others could benefit. His surgery was a success because it helped other people."
Marsden called the artificial heart device his "mama" because he was attached to a 350-pound console by various lines -- his "umbilical cords." He had to push the console that operated his heart whereever he went.
He was unable, at the last minute, to attend Friday's heart-technology gathering in Salt Lake City.
A tearful Farrer hugged Walker, who is the first person in the Intermountain area to be implanted permanently with a HeartMate "left ventricular assist device." Because of her diabetes, she didn't qualify for a transplant. But she's part of a clinical trial to see if the LVAD, as it's called, can be used as a permanent solution for some of the 50,000 Americans who suffer from congestive heart failure.
Only 2,000 heart transplants are done each year, according to Dr. James W. Long, director of the artificial heart program.
The goal of the ongoing heart research is to "bring the device to permanancy and a high level of reliability" so that people won't have to die because so few hearts are available for transplant, said Dr. Don Olsen, director of the Artificial Heart Research Lab and one of three surgeons who implanted Barney Clark in 1982.
The LVAD is a major advance over the first artificial heart. It looks like a small water canteen and rides in the left side of Walker's abdomen near the diaphragm. Her own heart is in place and two tubes lead into different parts of it to provide the pumping action. Another line, including a small external air vent, connects outside of her body to a pager-size electronic box and two batteries, which are worn in a fanny pack or clipped to her clothing. The entire unit, including batteries, weighs only 5.5 pounds.
Anyone sitting nearby can hear Reid Clark's "heart beat," a gentle whoosh-whoosh as LVAD helps his heart pump. Clark, 71, was in the final stages of congestive heart failure. Because he was older than 65, he was listed on an "alternate" waiting list for transplant. Then he suffered a seizure of heart failure while hospitalized in Provo and was rushed to Salt Lake City, where he was implanted with an LVAD device on April 23. Ten days later, he went home.
Randy Case was saved by a slightly older version of LVAD. After he suffered double heart failure, a helicopter brought him to LDS Hospital, where an early-generation, air driven (newer ones like Walker's are electronic) and much bulkier heart pump, complete with external console, kept him alive for 16 months until he received a human heart transplant.
During the heart-tech tour, Farrer visited with Michael Cross, 21, as he worked out on the treadmill. He has the same HeartMate left-ventricular assist device as Walker. His, however, is intended to be temporary.
The Layton resident was implanted on July 17 and is now on a waiting list for a heart transplant. Doctors aren't sure what caused his heart to fail -- perhaps a virus, Long said -- but they know he'd be dead without the device.
Later, Farrer listened in wonder to the original model artificial heart, like the one placed in her husband nearly two decades before. The device looks like a conglomeration of tubes and metal attached to a fish tank. But it sounded, she said, "like music."
She was visibly emotional as she stood, for a moment, listening to the cadence of the liquid pumping in and out of the device -- "a welcome, familiar sound." Her new husband, Glen Farrer, watched with tears in his eyes.
Reid Clark, Walker, Cross and Case are "evidence that that great, momentous event was not in vain," Long said.
But heart technology is not standing still. Salt Lake doctors are helping to develop a HeartQuest pump -- the third generation of artificial heart technology. The HeartQuest is not much bigger than a yo-yo and nearly weightless. Its only moving part is a rotor suspended inside a magnetic field. It's silent. With only one moving part, it is expected to last much longer -- 10 to 15 years -- without having to be replaced. The batteries will likely stay charged longer, too. In case of total heart failure, two of the devices could be used, one to take over function for each side of the heart.
Its small size impressed Reid Clark. "You can eat a full meal with that," he laughed, adding that the size of the LVAD makes small meals mandatory. The LVAD he, Walker and Cross use is smaller than the old technology, but still it's a "tight squeeze" to implant it, Long said.
Long said that with Clark's artificial heart transplant, "flames of interest were ignited. There was fear it would disappear when Barney Clark died a few months after implantation. But that's not true. This technology has been kept alive and well."
So have the people who need it.