Surgeon Discusses Work on World's First Fully Artificial Heart
COLLEEN MCEDWARDS, CNN ANCHOR: Doctors are calling it a slight setback: An artificial heart patient was put back on a respirator today. Just yesterday, doctors in Louisville removed it, and their patient was sitting up and talking to his family. Still, as CNN's medical correspondent Elizabeth Cohen reports, this new heart is a big step for the patient and for medical science.</s>ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): This calf is walking around with an artificial heart, and this man just received the exact same kind of heart, and doctors at Jewish Hospital in Louisville hope that someday he'll be up and walking around too.</s>DR. LAMAN GRAY, TRANSPLANT SURGEON, UNIVERSITY OF LOUISVILLE: I think that is extremely encouraging what we've seen so far, and I think it has tremendous potential for huge success.</s>COHEN (voice-over): This artificial heart, unlike the ones from the 1980s, allows the patient to walk freely. The heart, computer chips that control it, and a small battery are inside the body. Outside, a battery pack worn like a belt powers the device. Doctors had not said much about the man who received the device, except that he's in his mid-to-late 50s and his had multiple heart attacks and chronic kidney failure. Without the artificial heart, they gave him less than a 20 percent chance of living through the next month. With the heart they make no promises about how long or how well he will live but they have high hopes.</s>GRAY: We would anticipate that the patient should be able to get out of the hospital, to resume I'd say -- an active lifestyle and stay more then normal -- but a active lifestyle. I would certainly anticipate he would be able to do normal activities. I do not think he could do athletics.</s>COHEN: But doctors say there are many things that can go wrong.</s>GRAY: You might have a lung problem. You could have infection problems. You could have stroke problems. Liver failure and kidney failure are the main ones. We have not experienced anything so far.</s>COHEN (on camera): Medical ethicists have worried did the company that makes the artificial heart fully inform the patient about all the risks. The company and the doctors say yes.</s>DR. ROBERT DOWLING, TRANSPLANT SURGEON: We told him it's going to be a big operation, and you might not make it through, and we also told him quite frankly and honestly there's a lot of unknowns -- how long the device is going to last is an unknown. Based on our information, we hope a year or longer. But we don't know that.</s>COHEN (voice-over): Dr. Dowling says given the uncertainty, it's the patient and the family, and not the surgeons who are the real medical pioneers. Elizabeth Cohen, CNN, Louisville, Kentucky.</s>MCEDWARDS: Joining us now is Dr. Rob Dowling, one of the surgeons who actually put that heart in the patient's chest. Dr. Dowling, thanks so much for being here.</s>DOWLING: All right, thank you.</s>MCEDWARDS: So the patient was put back on a respirator this morning, we understand. How big a setback is that?</s>DOWLING: Actually, I don't consider that a setback at all. He's very weak from before the surgery. He just got tired, and we didn't want him to work all that hard, and we just did it in a routine nonurgent fashion, to just to make it easier on him. So it's not a setback. We'll have him on for a matter of maybe a few more days, let him get his strength back up, and we'll have him right back off.</s>MCEDWARDS: And then take it off again. How much how much has he been able to do since the surgery?</s>DOWLING: He's able to fully move all his extremities. When the breathing tube was out, he was able to talk with his family members, he was able to communicate with the doctors and nurses. We were able to have him sitting up in bed, so he's coming along very nicely.</s>MCEDWARDS: Doctor, how sick was he when he agreed to this operation? I think a lot of people want to know why he agreed to have this done.</s>DOWLING: Well, he's a very, very intelligent man, and he understood his own mortality. In other words, he had a very good understanding of how sick he was and what his prognosis was. We have all types of statistical ways to look at his condition, and we can put that into kind of like computer models to determine someone's chance -- his chance, anyone's chance -- of surviving, and all our predictors indicated that his chance of not being alive in 30 days was 80 percent. Another way, of course, of saying that is he had less than a 20 percent chance of surviving 30 days.</s>MCEDWARDS: We've actually got some X-ray photos, I understand, that we can show people of the heart in the chest cavity. Can you explain, while we're looking at these, what's different about this artificial heart, different from others that have been used in the past.</s>DOWLING: Oh, yes -- oh, yes. Well, you can imagine the other artificial hearts were developed 15 years ago. So if you can just imagine all the differences in technology in the last 15 years have been incorporated into this device -- miniaturization, all the advances in electronics. So what used to be a controller that was almost the size of a refrigerator is now a controller that can fit in the palm of your hand -- extremely sophisticated. And the other major difference between the old devices, and even some of the devices used today, is everything's internal. So there are no wires, cables or lines coming through the skin, and that's a major advantage. We think that that's going to markedly decrease the risk of any infection or any bacteria getting inside the body, if there's nothing crossing the skin.</s>MCEDWARDS: Even some of the people who have been involved in this incredible achievement have talked about some of the ethical concerns that they have -- and I'm wondering for you what the ethical issues are.</s>DOWLING: To me, it's pretty straightforward: This man, without this therapy, was not going to survive. And he understood it all; his family understood it all. We explained it to him in great detail. We explained every possible risk that we could possibly conceive of in detail. We showed it to him in writing. We read to him word for word the consent form that it had been approved by all the appropriate IRBs. We even went out of our way to get approval from the ethics committee, who understood that the nature of the illness and the fact that this type of experimental surgery is justified, I think, rather easily in someone that we know, with a very high degree of certainty, has a very small chance of living in the short term.</s>MCEDWARDS: And just quickly, if you would, Dr. Dowling, do you foresee a point in the future when this type of heart is widely used, is widely implanted in people in this country?</s>DOWLING: This is the first step toward answering that question. I guess my short answer to the question is yes, that's what we think. We have the potential for that, and this is the first step in answering that question, and our initial result is very positive.</s>MCEDWARDS: Dr. Rob Dowling, thanks so much for your time this morning -- appreciate it.</s>DOWLING: OK, thank you. 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