UCLA surgeons will test artificial heart

By Lily Jamali
Daily Bruin Contributor

A team of UCLA surgeons in the Heart Transplant Program will
test an artificial heart device that may revolutionize cardiac
surgery.

The AbioCor Implantable Replacement Heart, developed and
manufactured by Abiomed Inc., received FDA approval to undergo
clinical trials on Jan. 30. Only five hospitals across the nation
will perform the trials, including the UCLA Medical Center.

At UCLA, after the device is installed in three pigs and one
cadaver later this month, surgeons expect to receive approval to
start implanting the device in live humans.

“We expect that the FDA will give full approval in early
March,” said Dr. Hillel Laks, director of the UCLA Heart and
Lung Transplant Program. “Probably by March or April, the
first transplants will take place.”

The artificial heart will replace the ventricle chambers which
pump blood to the rest of the body. Once installed, the patient may
be able to live with the device indefinitely. But the durability of
the synthetic replacement is uncertain.

“We don’t know how long these hearts will
last,” Laks said.

Patients can also live with the artificial heart until they are
removed from the donor waiting list.

“There are not enough hearts for the patients who need a
transplant,” Laks said. “So we must use assist
devices.”

Currently, patients suffering from heart failure must wait for a
donor heart in order to undergo a heart transplant. According to
Dr. Daniel Marelli, Director of the UCLA Total Artificial Heart
Project, 2,500 hearts are available every year for the 8,000
patients on the list. As a result, heart patients often wait for
two to three years. The AbioCor replacement has the potential to
eliminate this problem.

“A replacement heart is one of the holy grails of heart
surgery,” said Marelli said.

In addition to the supply benefits, the replacement heart would
eliminate the problem of rejection by the recipient’s immune
system.

“There is no rejection of the replacement because
it’s made of inert materials,” Marelli said of the
replacement, whose components include titanium and
polyetherurethane, a plastic rubbery substance.

Instances of coronary artery disease, which often occurs with a
donated heart, would also be decreased by the artificial
replacement.

“With a donor heart, you can get the disease within a few
years of the transplant,” said Jessica Bresson, a recent UCLA
graduate and Total Artificial Heart project manager.

According to Bresson, patients must meet certain eligibility
requirements to receive the synthetic heart replacement once it is
initially performed on humans.

“The main criteria for patients undergoing this is that it
is expected that they will die of heart failure in 30 days,”
Bresson said.

Although there are numerous benefits to the innovation, certain
negative aspects do exist.

“You have two other major problems,” Laks said.
“One of them is the power source. We do not have batteries
that can last forever so the batteries that power the heart have to
constantly be recharged through the skin.”

“The other problem is the interface between blood and
foreign surfaces where clots can form,” he added. “So
patients have to take anti-coagulants.”

Anti-coagulants prevent clotting, but, according to Laks, a
patient taking such medicine can suffer from bleeding if they take
too much while running the risk of stroke if they don’t take
enough.

Despite the potential risks, members of the UCLA Heart
Transplant Program remain optimistic about the new innovation.

“We’re ready,” Bresson said. “We are
very eager to start.”

THE ABIOCOR IMPLANTABLE REPLACEMENT HEART The
implantable heart replaces the ventricles of the human heart and
operates on battery power. SOURCE:
www.abiomed.com/prodtech/Fctrials.html Original graphic by ADAM
BROWN/Daily Bruin Web adaptation by JUSTIN HONG and NATALIE
DAVIS