An Artificial Heart

Although Houston's Dr. Denton A. Cooley has transplanted more human hearts than any other surgeon, he still finds them in short supply. So last week he implanted the world's first completely artificial heart as a stopgap measure while he and the patient waited for a suitable heart donor.

On the operating table at St. Luke's Episcopal Hospital was Haskell Karp, 47, a printing estimator from Skokie,III., his heart drastically damaged by coronary-artery disease. Karp had had an implanted pacemaker for eleven months, but it was failing. Cooley first tried to save him by cutting out the dead area of heart muscle and stitching the sides of the hole together with a piece of Dacron for reinforcement. But when this was done, Karp's heart refused to beat spontaneously. Karp had been linked during the operation to a heart-lung machine, both breathing for him and pumping his blood, but this could keep him alive for only a few hours. Better, Cooley decided, to remove the useless heart and implant an artificial heart, leaving Karp's lungs to oxygenate his blood.

Source of Power. Standing by was Argentine-born Dr. Domingo Liotta of the Baylor College of Medicine, who has worked on artificial hearts for ten years. He now had ready a device that might keep Karp alive for a week or two. It is about the same size as a natural heart and is made of Silastic (a silicone plastic), with Dacron cuffs for attachment to the "distributor cap," or blood-vessel connections, in the remnant of Karp's own heart. It is self-contained except for one essential ingredient: a power system to deliver a steady, pumping beat. This must come from an external console as big as a refrigerator standing at the bedside, to which the artificial heart is attached by two thin air hoses.

With the artificial heart in place, Cooley led these tubes out through the cut in Karp's chest wall. The heart-lung machine was switched off and the console switched on. At a slow-normal heart rate, the pump alternately sent a volume of carbon dioxide under pressure into sacs in the artificial heart to force blood out of the ventricles to the lungs and the rest of the body, then relaxed this pressure to let the heart refill with blood.

Karp soon regained consciousness and obeyed commands to move his hands and wiggle his toes. Next morning, with a breathing tube removed from his throat, he said a few words. His wife Shirley issued an appeal for a heart donor. At week's end, though no donor was yet in sight, Karp was holding up well and Surgeon Cooley was standing by, eager to remove the artificial device and replace it with a natural heart.

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