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Vendredi, 02 Décembre 2011 12:30

Dec. 2, 1982: Barney Clark Takes One for the Team

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Barney Clark1982: A Seattle dentist named Barney Clark becomes the first human recipient of a permanent artificial heart. He survives the heart, and the accompanying media circus, for 112 days.

Clark, 61, was the ideal candidate, suffering from congestive heart failure so debilitating that he had trouble walking from his bedroom to the bathroom. Doctors determined that he was too sick to be eligible for a heart transplant, leaving the implant of an artificial heart his only option.

Clark’s predicament coincided with the FDA approving a new artificial heart for human implantation, a device known as the Jarvik 7. It was named for one of its key developers, Dr. Robert Jarvik, who had been building and refining artificial hearts since his student days under artificial-organ pioneer Dr. Willem Kolff at the University of Utah.

The Jarvik 7 was state-of-the-art for its time, and was the first one designed for permanent use. It employed a heart-shaped pump that was implanted into the patient. An external pneumatic compressor, connected to the pump by tubes running through the chest wall, regulated blood flow.

The major problem with these devices — apart from the fact that the washing-machine–sized air compressor left the patient virtually immobilized — was the threat of infection and associated pulmonary problems. This had proven to be the Achilles’ heel of every previous artificial heart used on both human and animal subjects. And so it would be in Barney Clark’s case.

Clark understood going in that his chance of long-term survival was virtually nil, but agreed to undergo the surgery in the interest of advancing science. The implant was performed at the University of Utah by Dr. William DeVries, and the Jarvik 7 functioned as expected.

Before the surgery, Clark told doctors he didn’t expect to survive more than a few days with his new heart, and no one seemed inclined to argue with him. But a few days turned into a few weeks and then a few months. Clark was still alive, but he was miserable: constantly plagued by infections, drifting into and out of consciousness, at several points asking to be allowed to die. He also suffered from chronic clotting, which led to a series of strokes.

All the principals involved agreed beforehand that there would be no individual talking to the media, that all information would be sent out through the university’s press office. Despite the moderate approach, reporters swiftly glommed onto the story, and Barney Clark’s saga became international news. Doctors were dunned for continual progress reports, while reporters turned Clark and his “stoic” wife into folk heroes.

The intense coverage also touched off a renewed debate about the ethics of using artificial organs in hopeless situations. Bioethics was a new field then, but there were plenty of critics who felt the Jarvik 7 was not ready for human implantation, and that the process for approving it had been flawed.

This was all beyond Clark, though, who died March 23, 1983. He had survived for 112 days.

The second patient to receive a Jarvik 7, an Indiana man named Bill Schroeder, lived 620 days. Unlike Clark, Schroeder initially responded well to the surgery, so much so that he was able to take a phone call from President Ronald Reagan and ride in a parade down the main street of his hometown.

But soon enough the complications caught up with him, too, and he died. So there was progress, but it wasn’t really success.

To this day, no artificial heart has proved effective as a permanent replacement for nature’s own. They’re used only as stopgaps for patients waiting for a human donor and whose own hearts are so damaged that less-invasive devices, like portable pumps, can’t help them.

Artificial-heart research, however, goes on.

Source: Scientific American, other

Photo: Artificial-heart recipient Barney Clark smiles at his surgeon, Dr. William DeVries, in Salt Lake City on the day after the historic implantation./Associated Press

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