http://www.corriere.it/english/articoli/2007/12_Dicembre/11/HeartImplant.shtml
Italy’s First Total Artificial Heart Implant
Fifty-four-year-old operated at Padua. Transplants in Italy began at the same
hospital twenty-two years ago.
MILAN – Twenty-two years ago, Italy’s first transplant of a donor human heart
took place here. Now, Padua has witnessed the country’s first implant of a
total artificial heart. It seems that the local cardiosurgery unit has a taste
for firsts. Twenty-two years ago, the surgeon was Vincenzo Gallucci. Today,
Gino Gerosa has taken over from his trail-blazing predecessor, who died
tragically in a car accident. In fact, the centre Professor Gerosa directs is
named after Vincenzo Gallucci.
A fifty-four-year-old man from Veneto is the first Italian to receive a
compressed air-driven, polyurethane heart. The heart doesn’t beat: it blows.
The recipient was on the operating table for thirteen hours a week ago,
surrounded by a ten-strong team of surgeons, anaesthetists and nurses, as well
as several bioengineers, all led by the fifty-year-old Professor Gerosa. The
patient regained consciousness forty-eight hours later on his birthday, waking
to new hope for the future. He no longer has his heart, which was beyond repair
and had compromised other vital organs, including his liver and kidneys. In
fact, the man would not have survived a transplant or anti-rejection treatment.
Now he can recover – with the artificial heart, all he needs is anti-thrombosis
therapy – and get ready to receive a real heart.
In the meantime, he is the first Italian with a rhythmic beat in his chest and
a dead man’s ECG reading. The ECG is completely flat because in effect he has
no heart. How long he will stay like depends on various factors. Some four
hundred totally artificial hearts, of which a hundred or so are the latest
model, have been implanted since the 1990s. The record holder is a German
patient, who lived for two years with a compressed-air pump.
The “heartless” Italian was in a serious condition when he went into hospital
at Padua on 30 November. Two previous operations had been unable to repair his
natural heart. His life expectancy was low as he lay without hope, intubated
and attached to a machine that supported his failing heart. He needed a cardiac
output of at least nine litres but even with help his own heart was unable to
deliver more than four. The health of his other organs was beyond recovery. But
Professor Gerosa had been waiting for the right patient for the CardioWest TAH
(Total Artificial Heart) and the operation went ahead.
The news was announced yesterday, when doctors were sure that the patient was
making a satisfactory recovery. Professor Gerosa notes: “The device implanted
does more than enable the patient to survive. It gives him the assurance of an
excellent quality of life”. The president of the Veneto regional authority,
Giancarlo Galan, was delighted: “Another prestigious achievement for our health
service and a source of pride and satisfaction for Veneto residents”. The
artificial heart weighs 160 grams, about half the weight of a natural organ. It
is made up of two ventricular chambers, each comprising a semi-rigid
polyurethane housing containing a flexible membrane that separates the chamber
for the patient’s blood from the air chamber that pumps the blood into
circulation. The polyurethane diaphragms “beat”, driven by compressed air from
a fixed or portable external console. The portable version, which weighs one
and a half kilograms and can be
shoulder slung, has a maximum running time of six hours, after which it has to
be recharged with new canisters of compressed air. The cost of the artificial
heart implant alone is eight thousand euros. The next step is a totally
artificial, totally implantable heart with its own source of energy. It’s ready
and waiting.
Mario Pappagallo
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