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ARTICLE |

Permanent Heart Substitution: Better Solutions Lie Ahead FREE

William S. Pierce, MD
JAMA. 1988;259(6):891-891. 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

REFERENCES

Pennock JL, Pierce WS, Campbell DB, et al:  Mechanical support of the circulation followed by cardiac transplantation. J Thorac Cardiovasc Surg 1986;;92:994-1004.
Griffith BP, Hardesty RL, Kormos RL, et al:  Temporary use of the Jarvik-7 total artificial heart before transplantation. N Engl J Med 1987;;316:130-134.
Griffith BP, Kormos RL, Dummer SJ, et al:  The artificial heart: Infection-related mortality and its effect on transplantation. Ann Thorac Surg , in press.
Kolff WJ, Akutsu T, Dreyer B, et al:  Artificial heart inside the chest and the use of polyurethane for making valves and aortas. Trans Am Soc Artif Intern Organs 1959;;7:198.
Pierce WS:  Artificial hearts and blood pumps in the treatment of profound heart failure. Circulation 1983;;68:883-888.
Jarvik RK:  The total artificial heart. Sci Am 1981;;244:74.
Rosenberg G, Snyder A, Landis DL, et al:  An electric motor-driven total artificial heart: Seven months survival in the calf. Trans Am Soc Artif Intern Organs 1984;;30:69-74.

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Pennock JL, Pierce WS, Campbell DB, et al:  Mechanical support of the circulation followed by cardiac transplantation. J Thorac Cardiovasc Surg 1986;;92:994-1004.
Griffith BP, Hardesty RL, Kormos RL, et al:  Temporary use of the Jarvik-7 total artificial heart before transplantation. N Engl J Med 1987;;316:130-134.
Griffith BP, Kormos RL, Dummer SJ, et al:  The artificial heart: Infection-related mortality and its effect on transplantation. Ann Thorac Surg , in press.
Kolff WJ, Akutsu T, Dreyer B, et al:  Artificial heart inside the chest and the use of polyurethane for making valves and aortas. Trans Am Soc Artif Intern Organs 1959;;7:198.
Pierce WS:  Artificial hearts and blood pumps in the treatment of profound heart failure. Circulation 1983;;68:883-888.
Jarvik RK:  The total artificial heart. Sci Am 1981;;244:74.
Rosenberg G, Snyder A, Landis DL, et al:  An electric motor-driven total artificial heart: Seven months survival in the calf. Trans Am Soc Artif Intern Organs 1984;;30:69-74.
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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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