This Jarvik-7 total artificial heart was used in the first authorized bridge to organ transplant operation. A bridge to transplantation is a temporary measure that replacs a failing heart with a mechanical pump while waiting for a human heart for implantation. Jack G. Copeland, M.D, performed the surgery on August 29, 1985 at the University Medical Center, University of Arizona. The patient, 25 year old Michael Drummond, lived with the mechanical pump for nine days until a donor heart could be implanted. Later, Drummond kept the heart in his home before its donation to the Smithsonian.
Robert Jarvik (b. 1946) graduated from Syracuse University and earned a master’s degree in medical engineering from New York University. Then, at to the University of Utah Medical School, he earned an MD and was influenced by Wilhelm Johan Kolff, a Dutch-born physician who had developed a dialysis machine and was working on artificial organs. The first Jarvik-7 artificial heart was implanted in Barney Clark in 1982.
“The Mechanical Heart” also known as the Michigan Heart had the ability to bypass the right and left side of the patient’s heart allowing surgeons a “dry” field on which to work. The Dodrill-GMR heart project was a collaborative effort led by Dr. Forest Dewey Dodrill of Harper Hospital in Detroit, Michigan and General Motors Research Laboratory.
The Dodrill-GMR Heart was used in the first successful open heart operation July 3, 1952. The patient, a forty-one year old male, had a deformed mitral valve which was successfully repaired
Sewell built the pneumatically powered pump for his medical thesis at Yale University. He graduated in 1950. The object of the pump was to by-pass the right side of a dog's heart, and to look for any abnormalities the pump may have caused to the heart or the blood.
A cannula was inserted into the animal’s jugular vein and maneuvered into the right auricle and finally into the vena cava. Compressed air was used to pump blood through the dog's system. The first experiment took place in June 1949. The artificial heart worked and the dog made a complete recovery.
The total cost of the pump came to $24.80. The most expensive part at $9.00 was the erector set and motor.
This perfusion pump was invented by aviator Charles Lindbergh and Dr. Alexis Carrel, recipient of the 1912 Nobel Prize for Physiology and Medicine for his work in vascular surgery.
The glass pump was used to preserve animal organs outside the body, by pushing "artificial blood" through the pump and into the organ by way of a tube connected to the organ's artery keeping the organ alive for weeks. The Lindbergh-Carrel perfusion pump led to the development of the heart-lung machine and the feasibility of stopping the heart for open-heart surgery.
The ventricular assist device or the intrathoracic bypass pump as it was originally named was developed by a surgical research team led by Michael DeBakey (1908-2008), C. William Hall (1922-1992) and Domingo Liotta (1924- ) at Baylor University College of Medicine in Houston, Texas. The pneumatically powered pump is made of Silastic® and utilizes two ball-type valves to direct blood flow in one direction. It was the first bypass pump implanted in a human.
Heart assist devices or ventricular assist devices (VAD’s) are used to provide circulatory assistance to a weakened heart. The device helps pump blood through the aortic valve and into the aorta supplying blood to the rest of the body.
On July 18, 1963 this intrathoracic bypass pump was implanted into a 42 year old man who had undergone surgery to replace a diseased aortic valve. Hours later the patient suffered a cardiac arrest developing anuria (the decline of urine production) and fluid (edema) build up in his lungs. Although the pump help to relieve the edema the patients urine output never increased. The patient died four days after the pump was implanted.
Doctors considered the pump and other new mechanical devices such as the pacemaker and artificial heart valves successful, but they discovered that supplementing and indeed replacing the natural heart would not be easy. Among the problems which they encountered included damage to blood cells and the rejection of the device by the body. In the end physicians concluded, due to its long term support capabilities and the increase of blood circulation an internal artificial pump was feasible.
Willem J. Kolff (1911-2009) was a Dutch physician who in 1943, despite the cloud of Nazi occupation, devised the first workable artificial kidney. In 1947, Dr. Kolff brought two of his machines to America: one was installed in Mount Sinai Hospital in New York City, and the other in Montreal. John Merrill and Carl Walters, physicians at Peter Bent Brigham Hospital in Boston, were inspired by Kolff’s achievement, and developed another machine based on his design. Dr. Merrill donated this example to the Smithsonian in 1970. An inscription reads “MADE BY / EDWARD A. OLSON CO. / ASHLAND, MASS. USA.”
Ref: Waldemar Kaempffert, “Artificial Kidney for Treatment of Uremic Poisoning Is Now in Use in New York,” New York Times (March 30, 1947), p. E9.
Francis Burns, “New Artificial Kidney Operated at Brigham,” Boston Globe (May 9, 1948), pp. C1, C22.
Edward A. Olson Co., The Kolff-Brigham Artificial Kidney (Ashland, Ma., n.d.).
“Willem Kolff, Doctor Who Invented Kidney and Heart Machines, Dies at 97,” New York Times (Feb. 13, 2009), p. A23.
“Dr. John Merrill, Transplant Pioneer, Dies in Boating Accident,” New York Times (April 10, 1984), p. B10.
“Strictly a Lathe and Drill Man, He Made the Artificial Kidney,” Boston Globe (March 9, 1959), p. 22.
This dissected Jarvik-7 Total Artificial Heart (TAH), was implanted in Murray Haydon, the third artificial heart recipient, July 20, 1986. The operation took place at the Humana Heart Institute International in Louisville, Kentucky. Haydon lived with the implanted blood pump for 488 days. The Jarvik-7 TAH has a right and left ventricle with four tilting disc valves. Each ventricle contains a flexible diaphragm constructed of multi layered polyurethane. The TAH is driven by an external pneumatic pump, the Utah drive System II. Mr. Haydon lived with the artificial heart for 488 days.
William DeVries, a cardio-thoracic surgeon became recognized around the world as the surgeon who implanted the first Jarvik-7 in dentist Barney Clark in December 1982. He received his medical degree from the University of Utah, and completed his residency at the Duke Medical Center. He was a research associate in the Kolff laboratory while still in medical school.
Numerous scientists and engineers worked on the development of the artificial heart, but it was Robert Jarvik, M.D. in the Kolff laboratory who changed the TAH from a sphere to an elliptical shape allowing it to fit more easily into the chest cavity. Jarvik also added a third and fourth bladder to each ventricle creating more flexibility and durability. The addition of two extra rubber bellows allowed for more vigorous blood flow. His improvements allowed the correct amount of blood 100cc's, to circulate through the body. Jarvik also experimented with materials using polyurethane Biomar to create surfaces inside the housing which prevented blood thrombosis or clotting. The highly publicized artificial heart operations brought attention to the triumphs of scientific technology as well as its limitations, and costs, both literal and figurative.
The DeBakey paracorporeal left ventricular assist device was developed by scientists at Baylor and Rice Universities. The pump is gas generated and is made with Dacron reinforced with Salastic. A diaphragm separates the gas chamber from the blood chamber.
This example was developed by Dr. Michael DeBakey (1908-2008) in the mid-1960's. The pump lies outside the body, one tube is inserted into the left atrium, and a second tube goes into the right auxiliary artery. DeBakey reported on three cases using this pump in a 1971 article "Left Ventricular Bypass Pump for Cardiac Assistance" in The American Journal of Cardiology.
This pump is a direct descendant of an earlier by-pass pump developed in DeBakey’s laboratory. See Accession 256189.01.
This blood pump/drive unit is the original version of the Novacor Left Ventricular Assist (LVAS). It is the world's first clinically implanted electromechanical Ventricular Assist Device (VAD). While some researchers worked on developing a total artificial heart as a bridge to transplant several groups of scientists and engineers worked on developing the smaller heart assist device. In select cases the LVAD can be used as a long term recovery solution (destination therapy) to chronic heart failure. Groups working on both the artificial heart and VAD's encountered many of the same problems, particularly material compatibility to avoid blood clotting. In 1998, the Novacor LVAS was given FDA approval as a bridge to transplant.
A Ventricualr Assist Device (VAD) is a mechanical pump used to partially or completely replace a diseased human heart. Unlike a Total Artificial Heart, the patient’s human heart is left in place. The VAD assists the ventricles push blood through the body.
This version of the N100PC ventricular assist drive without encapsulation shows the inner workings of the pump. The N100PC was used in clinical trials between1993 and 2011.
A Ventricular Assist Device (VAD), is a mechanical pump used to partially or completely replace a diseased human heart. Unlike a total artificial heart, the patient’s human heart is left in place, helping the damaged to push blood through the body.
This is the first total artificial heart implanted in a human body. It was developed by Domingo Liotta and implanted by surgeon Denton Cooley (1920-2016) on April 4, 1969, at St. Luke's Episcopal Hospital in Houston. The recipient, Haskell Karp, lived for sixty-four hours with the artificial heart pumping oxygenated blood through his body until a human heart was available for transplant.
Although Karp died soon after receiving a real heart, and some criticized the surgery as unethical because it was without formal review by the medical community, the procedure demonstrated the viability of artificial hearts as a bridge to transplant in cardiac patients.
This is one side of an artificial heart made to be used with a drive system developed at NASA's Lewis Research Center (the John H. Glenn Research Center at Lewis Field) for Dr.Willem Kolff in the Department of Artificial Organs at the Cleveland Clinic Foundation, Cleveland, Ohio. The heart was driven with air, and used electric coils as transducers. The drive system regulated and provided air to the ventricles.
The heart is a rounded U-shape with two openings at the top for artificial ball heart valves. It is of made of silicone, and has layered Dacron netting for strength. At the front of the heart are two tubes which connect to the drive system. On the opposite side from the tube, there is a system of wires and coils implanted into the wall of the heart. Wires extend from top of the heart and connect to the coil system. No pumping membranes or valves are present. There are three prongs inside one of the blood openings, that shows where valve would be positioned.
This artificial heart was made by Tetsuzo Akutsu (1922-2007), and was one of the earliest (1962-1964) to be developed in Kolff's laboratory. Experiments with dogs lasting approximately twenty-four hours demonstrated the feasibility of this design, however, several problems including thrombosis and emboli were a serious complication.
The CardioWest Artificial Heart is a smaller version of the Jarvik-7 Artificial Heart developed in the 1980's at the University of Utah. The CardioWest is used as a bridge to transplant, a temporary measure replacing a failing diseased heart with a mechanical pump while waiting for a human heart for transplantation.
The Soft Shell Mushroom Total Artificial Heart has an actively opening and closing mushroom-shaped inflow valve. An air sac around the stem of the mushroom when inflated expels the blood from the ventricle during systole. A hard septum is held partly over the left ventricle. Dacron netting is attached to it to constrain the ventricle during systole. The heart was made by Willim Kolff's sons Alfred and Cornelis (Case), and implanted by Dr. Clifford Kwan-Gett in the summer of 1968 at the University of Utah.
This test rig was used to analyze the ventricles made for the Atomic Energy Artificial Heart. An artificial heart driven by atomic energy was financed by the Atomic Energy Commission, and by Energy Research and Development Administration (ERDA). In 1977 the ERDA became the United States Department of Energy, which lost interest in the development of a nuclear heart. The engine was made by North America/Phillips while the silastic ventricles were made in Kolff's laboratory. Kolff replaced the Sterling engine with a small electromotor on the pump and obtained survival of a calf for 35 days with this artificial heart.
The AbioCor Total Artificial Heart is the first electro-hydraulic artificial heart implanted in a human. Approved by the United States Food and Drug Administration for clinical trials, this AbioCor artificial heart was implanted in Robert Tools by cardiac surgeons Laman A. Gray Jr. and Robert D. Dowling on July 2, 2001, at Jewish Hospital in Louisville, Kentucky. The historic operation marked the first time an artificial heart was used as a permanent replacement for a human heart since the air-powered Jarvik-7 artificial heart more than fifteen years before.
The AbioCor is a two-chamber pump designed to perform like a natural human heart. It is powered by batteries, and pumps more than 2.5 gallons of blood a minute to the lungs and then to the rest of the body.
Tools, who suffered from irreversible congestive heart failure, chose to have his diseased heart removed and replaced with the plastic and titanium pump. He lived for five months, well beyond the clinical trials goal of sixty days.
The development of the AbioCor involved a team of engineers, scientists, and physicians from across the United States. Completely contained within the body, no tubes protrude through the skin, nor is the patient tethered to a noisy bedside console, as with air-powered hearts. Instead the heart is powered by rechargeable batteries and microcomputer technology that regulates the heartbeat according to the patient's activities.
Yorick is a plastic male skeleton imbedded with electronic and mechanical devices used to replace worn body parts. Yorick was created by Ed Mueller, an engineer in the Division of Mechanical and Material Sciences at the United States Food and Drug Administration (FDA), in Washington, D.C.
Yorick often made appearances at schools, Scout meetings, and hospitals to educate students about bionics and current research on implant design development.
Some of the devices implanted in Yorick are: cranial plate, silicone nose, carbon tooth root, interocular lens, cochlear implant, heart valve, artificial heart, cardiac pacemaker, infusion port, vascular grafts, urinary sphincter prosthesis, artificial patella, bone plate, artificial tendons, bone growth stimulator, and artificial hip, knee, elbow, and finger joints.
The electrohydraulic heart has only one moving part, the reversible impeller or turbine. Blood does not go through the impeller, therefore there is not supposed to a concern with blood damage. Numerous scientists and engineers worked on the development of the artificial heart, but it was Robert Jarvik, M.D. in the Kolff laboratory who changed the TAH from a sphere to an elliptical shape allowing it to fit more easily into the chest cavity. Jarvik also added a third and fourth bladder to each ventricle creating more flexibility and durability. The addition of two extra rubber bellows allowed for more vigerous blood flow. His improvements allowed the correct amount of blood 100cc's, to circulate through the body. Jarvik also experimented with materials using polyurethane Biomar to create surfaces inside the housing which prevented blood thrombosis or clotting.
The first implantation of a Jarvik-7 Total Artificial Heart occurred December 1982. The TAH was implanted in Barney Clark by Dr. William DeVries at the University of Utah Medical Center. The highly publicized artificial heart operations brought attention to the triumphs of scientific technology its limitations,and its costs, both literal and figurative.
This polyurethane right ventricular assist device (RVAD), is made by vacuum forming and assumes the pumping function of the right ventricle. It can also be used in conjunction with a left ventricular assist (LVAD) to form a total artificial heart. The flexible, multilayer diaphragm separates the blood and gas chambers of a circular ventricle and has a volume of 50 cc. A graphite coating acts as a lubricant between the diaphragm's layers. An air drive line tube emerges from the base of the pump sac with Dacron netting at the junction where clotting is likely to occur. Dacron's rough surface anchors and isolates blood clots to prevent embolization. The tube delivers compressed air to the gas chamber to actuate the pumping diaphragm. Dacron fibrils are at the junction between the diaphragm and blood chamber housing. Clots are more likely to form inside ventricles with rough intima. Dacron fibrils had been applied inside with thin pellethane and loose fibrils removed with air pressure. Remaining fibrils are coated with a thin pellethane layer for a smooth surface. Two snouts with sinus valsavae, petal-shaped backflow regions. Inflow port contains a bell-shaped pellethane cuff for connecting to the right atrium. The cuff is lined on the outside with Dacron velour. The outflow port contains a corrugated Dacron graft for connection to the pulmonary artery. Polyurethane trileaflet valves are cheaper and cause less trauma to the blood than mechanical valves.
The RVAD is accompanied by a quality-control checklist for the vacuum-formed housing. No quick connects. Indicates mold temperature and pellethane type and thickness. Chronic quality. Approved for mandatory .060 thickness of port walls. Checklist also includes condition of valve junctions, diaphragm-housing junction, and webbing.
A heart-lung machine takes blood from a patient, oxygenates it, and pumps it back into the patient's body. Dr. John H. Gibbon developed the first successful machine of this sort, and demonstrated it at the Jefferson Hospital in Philadelphia in 1953. While that project was underway, Dr. John W. Kirklin, a surgeon at the Mayo Clinic in Rochester, Minnesota, was assembling a team to develop, produce and test a new and improved machine. The first procedure with that machine was performed in March 1955. This example is a Mayo-Gibbon heart-lung machine, Model 1010B.
Ref: “HEART-LUNG DEVICE SUCCESS IN SURGERY,” New York Times (May 30, 1953), p. 17.
John H. Gibbon, Jr., et. al., “Oxygenating Unit for Extracorporeal Circulation Devices,” U.S. Patent 2,702,035 (Feb. 15, 1955), assigned to the Jefferson Medical College.
Richard C. Daly, et. al., “Fifty Years of Open Heart Surgery at the Mayo Clinic,” Mayo Clinic Proceedings 80 (2005): 636-640.
“John W. Kirklin is Dead at 86; Innovator in Cardiac Surgery,” New York Times (April 30, 2004), p. A25.