Senior Physician Speaker Series
Curated and hosted by Sam Yared, MD images from bivacor. com
Topic: Update on the Total Artificial Heart
At the December meeting of the Senior Physicians Committee, Dr. Sam Yared, chair, shared a presentation regarding updates on the total artificial heart. Dr. Yared is a retired cardiothoracic surgeon with a wealth of knowledge, as he continues to stay up to date on the most recent discoveries in the field. He participated in the implantation of the artificial heart at the Texas Heart Institute in Houston, Texas in 1981 and at the Humana Heart Institute in Louisville in 1984.
The Future of Cardiac Replacement: From Mechanical Circuits to Bioprinted Hearts
The evolution of cardiac replacement therapy reflects one of the most ambitious pursuits in modern medicine: developing a reliable alternative to human heart transplantation. For decades, cardiologists, surgeons and bioengineers have worked to solve a simple but persistent problem: there will never be enough donor hearts.
The lecture traces this journey from early Total Artificial Heart( TAH) prototypes to emerging bioprinting technologies that may one day make transplantation both personalized and limitless.
Foundation: The Early Era of the Artificial Heart
Dr. Stanley Crawford and Dr. Domingo Liotta implanted the first LVAD at the Methodist Hospital in Houston, Texas on July 19, 1963. Dr. Michael DeBakey worked with Dr. Liotta to improve the design of the TAH. While in Washington, D. C., advocating for the approval and the support for the project, a sick patient at the Texas Heart Institute required emergency support. Dr. Denton Cooley and Dr. Liotta implanted the first artificial heart at the Texas Heart Institute.
30 LOUISVILLE MEDICINE
Guest Speaker: Sam Yared, MD
The story of the artificial heart also begins with visionaries like Dr. Willem Kolff and Dr. Robert Jarvik, whose collaboration produced the Jarvik-7, the first total artificial heart implanted as a permanent replacement. The case of Barney Clark done in 1982, although medically and ethically complex, proved the concept: a mechanical device could sustain human life when native cardiac dysfunction was irreversible.
Dr. William Devries moved to Louisville to the Humana Heart Institute to join Dr. Allen Lansing and Dr. Yared and his group. The patient was Bill Schrader, who had severe coronary artery disease, acute myocardial infarction and had previous bypass surgery. He was a smoker and not a candidate for additional procedures because of his severe left ventricular dysfunction. On Nov. 24, 1984, he received a total artificial heart using the Jarvik-7. On December 13, he suffered a stroke, most likely due to a clot to his brain from the artificial heart device, although he was on multiple anticoagulant drugs.
Two additional artificial hearts were implanted in Louisville( see table 1).
The FDA stopped the initial experiments because of complications. It is worth mentioning that the first attempt of bridge to transplant with the bilateral ventricular assist device was performed by Dr. Laman Gray in Louisville at Jewish Hospital in November 1987.
The Modern Mechanical Era: SYNCARDIA
Contemporary artificial heart systems like the SYNCARDIA TAH represent the maturation of decades of engineering. The device is smaller, more durable and far more portable( see pictures).
Patients can now ambulate with wearable pneumatic devices, instead of being attached to a mechanical box. The modern TAH provides meaningful survival and quality of life as a bridge to heart transplant.
A Biological Future: The Rise of 3-D Bioprinting
Unlike synthetic mechanical systems, bioprinted tissues aspire to biological integration, electrodynamic coupling, vascularization, immune compatibility and growth.