Jack Fisher broke a record Saturday as the person to live longest on an electric blood pump to help his ailing heart. More than anything, though, the 46-year-old bond salesman hopes for a transplant.
"It's not a record I want to break," he said, grinning.But "I don't mind" being a medical pioneer, Fisher said, relaxing in his hospital room with his wife, Edie, 39, and four of their five daughters. The girls arrived Thursday from the family's home in Rumson, N.J., to spend Easter weekend with their father.
Surgeons at Presbyterian-University Hospital of Pittsburgh implanted a Novacor left ventricular assist device into a dying Fisher in an operation that ended Dec. 9. Saturday was his 107th day with the device while awaiting a transplant.
He had been diagnosed 31/2 years earlier with cardiomyopathy, a disease of unknown origin that damages heart muscle.
"I think the toughest part is knowing that in order for you to live, you have to take something (a heart) from somebody else," he said.
The 11/2-pound, polyurethane pump was implanted behind the muscle of the front abdominal wall as a temporary means of helping the left ventricle, which does 85 percent of the heart's work.
Unlike the Jarvik and other total artificial hearts, the Novacor and other assist devices do not require removing the patient's own diseased heart. They are intended to keep people alive while awaiting transplants, although eventually a long-term device may be developed.
The Novacor is the only one of the devices to be driven by electricity, making it less bulky than the air-driven models.
A heart-assist device driven by electricity, rather than compressed air, allows the patient awaiting a transplant more mobility and reduces the risk of infection, said Dr. Peer Portner, president of the California-based Novacor division of Baxter Healthcare Corp.
Alison, 13, also has mixed emotions about her father's feat.
"It's kind of funny to think of my dad breaking a record. I mean, I thought it would be a different rec-ord that he'd break, not this one," she said.
A tube protruding from Fisher's abdomen carries electrical wires that feed into a tiny white box on his lap. The box, in turn, is connected by 20 feet of cable to a 440-pound console and computer that control the pump and monitor his heart rhythm. A technician pushes the equipment beside him on his daily strolls down hospital hallways.
Ever present is the loud, constant click of the pump as it distributes blood through Fisher's body. The noise doesn't bother him, and the pump is painless.
"If this stops clicking, I'm in trouble," he said.
Dr. Robert Kormos, one of his surgeons, says it's hard to say how long the Novacor pump could sustain Fisher.
"It's been essentially working faultlessly," Kormos said.
Since the first Novacor implant in 1984 at Stanford University, 41 of the pumps have been used on people awaiting transplantation, Portner said.
Eighteen of the 41 patients went on to receive human hearts and were alive as of Friday, Portner said. Of the remaining 23, Fisher and three others were still on the device, 15 died while on the Novacor, and four died after getting a transplant.
Until Saturday, the record for the most time on a left-ventrical assist device was 106 days, set in January by a 64-year-old patient at Methodist Hospital in Houston who spent that long on a Novacor before receiving a human heart. The transplant was not successful and he died three days later.
The survival record for a total artificial heart is much longer: William Schroeder of Jasper, Ind., lived 620 days on one before he died in August 1986. But artificial heart patients have all had a variety of complications, and use of the devices as permanent replacements for diseased hearts has been largely suspended.
More than 1,200 Americans are awaiting heart transplants.
Fisher, on leave since January 1988 from Shearson Lehman Brothers in New York, says he is confident he'll pull through a transplant once a suitable donor heart is found.
He doesn't sit around worrying when his day will come.
"You don't have any control over it. There's nothing I can do," he said, shrugging. "These guys already took care of me once. I say they're going to take care of me again."
"He's always been one to fight the odds," his wife agreed. "He's already proven that here."