From Deseret News archives:
'82 heart implant sparked progress
U. team implanted Jarvik-7 in Barney Clark 25 years ago
It was also a different time, medically speaking, says Dr. Edward "Mike" Gilbert, professor of medicine, director of the heart failure treatment program and medical director for heart transplants at the U.
In 1982, the medical arsenal against a failing heart was sparse only a few centers were doing transplants, and medical management consisted primarily of digoxin, early oral vasodilator drugs and diuretics.
In the past 25 years, much has been learned about the activity of nerve and hormone systems in causing a weak heart to get larger and weaker. There have been hundreds of careful, prospective randomized trials to look at treatment outcomes, and multiple classes of medication have emerged, including beta blockers, ACE inhibitors and others.
Today, many people can be maintained for years with heart failure as a chronic condition. That wasn't the case back then. And electrophysiology working with the heart's electrical system is now possible, Gilbert says.
There is still a dearth, however, of donor hearts.
"It's still not a good disease, and the death rate is still pretty high with heart failure. But there's no question we've made good progress," Anderson says.
Today, stem cells offer hope of repairs for damaged heart tissue. It may be possible, Olsen thinks, to get stem cells to fix an area where heart cells have died. As to genetically engineering a heart itself, he's more skeptical. That requires specialized cells with electrical and circulatory capability and figuring out how to get cells to develop into valves. It's a very tall order.
The quest for ever-smaller, totally implantable, more perfect artificial hearts and heart-assist devices continues, but it is a "slow, but progressive" march, in Anderson's words. Jarvik later introduced a smaller, sleeker design; so have others. Several companies have their own iterations. The artificial heart is now both bridge and destination.
And it's a good bridge, Anderson says. As a destination therapy for those who will never get a transplant because they don't qualify, it's "pretty good for two years and better than the alternative, death." The infection rate is still a big problem, while clotting is less a problem than it was.
Recent comments
I have spent many years attempting to keep the Dr. Clark history of...
Don B. Olsen | Nov. 27, 2007 at 9:25 a.m.
There is no mention of Dr. James Long who is noted to be one of the...
No Name | Nov. 26, 2007 at 2:43 p.m.
I lived in Scotland in '82 and it was a huge story over there....
Anonymous | Nov. 25, 2007 at 9:09 p.m.
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