Permanent Heart Substitution: Better Solutions Lie Ahead

William S. Pierce, MD
JAMA. 1988;259(6):891. doi:10.1001/jama.1988.03720060059031.
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The articles by DeVries et al in this issue of The Journal document in the scientific literature the events surrounding the much publicized permanent heart replacement using the Jarvik-7 pneumatically powered artificial heart. Their reports define the serious problems that have cast a dark shadow on the currently available pneumatic heart: thromboemboli and infections. Unfortunately, given the present state of the art and science, these problems will not be readily solved. While the tenor of these articles is positive and DeVries and coworkers imply that additional permanent implants will be performed, the suggested solutions to these problems, primarily alterations in patient management, seem unlikely to reduce substantially the incidence of complications. Accordingly, adding patients to this series will serve only to document further the magnitude of the complications rather than to demonstrate an acceptable life-style in the recipient.

During the past several years, similar pneumatically powered mechanical hearts have been


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