Artificial heart recipient back on respirator

Transplant surgeons Dr. Laman Gray, left, and Dr. Robert Dowling discussed the procedure Wednesday in Louisville

LOUISVILLE, Kentucky (CNN) -- A man who received a totally contained artificial heart was put back on a respirator Thursday morning, but his transplant surgeon said the move should not be viewed as a setback.

"Actually, I don't consider that a setback at all," said Dr. Robert Dowling in an interview with CNN. "He's very weak from before the surgery and he just got tired, and we didn't want him to work all that hard. And we just did it in a routine, non-urgent fashion to make it easier on him."

The patient, described as a man in his mid to late 50s, underwent the revolutionary surgery Monday at Jewish Hospital. His name has not been released.

Dowling said the patient would remain on the respirator "a few more days" while his strength returns.

VIDEO CNN Medical Correspondent Elizabeth Cohen talks with Dr. Robert Dowling (July 4) Play video (QuickTime, Real or Windows Media) CNN's Rhonda Rowland goes through the history of the artificial heart (July 3) Play video (QuickTime, Real or Windows Media) (More)     MORE STORIES AbioCor latest innovation in crowded field     EXTRA INFORMATION Explainer: See a diagram of how the heart is implanted and powered   Timeline: What research led to the implantation of the artificial heart?     RESOURCES On The Scene: Elizabeth Cohen: Ethics of the artificial heart   CNN Access: Artificial heart surgeon discusses patient, operation     KEY FACTS: What is it? The AbioCor is a totally implantable artificial heart made of titanium and plastic. It weighs about 2 pounds. What does it do? The device pumps blood through the heart to the lungs and the rest of the body, simulating a living heartbeat. Who is it for? The AbioCor is designed for heart failure patients who have failed all existing therapies. If it is successful, about 100,000 patients a year could benefit. What does it cost? The AbioCor is estimated to cost about $70,000. Why is it important? Manufacturer Abiomed says AbioCor could be a viable alternative for patients with no other options. It could give them more freedom of movement, because they would not need to be tethered to large machines the way recipients of the first artificial heart were. It could also reduce the risk of infection because it is completely implanted -- no wires or tubes stick out of the patient's body.

"He's coming along very nicely," Dowling said, adding that the man was able to move all of his extremities and could speak with his family and doctors when the breathing tube was out Wednesday night.

Doctors continue to hail the implantation of the artificial heart as a major step forward.

"He is much better than Rob and I would have expected considering how sick he was," Dr. Laman Gray said Wednesday. He and Dowling implanted the heart Monday.

However, Gray warned that the procedure is experimental and there are bound to be complications.

"I can't even predict the complications that we are going to have to deal with in the future," said Gray. "And we will have them."

He described the heart as a "very smart device," and Dowling said information on the patient's condition is being provided by the heart on a "beat-by-beat basis."

The doctors described the man as so ill that he was unable to get out of his wheelchair. They said he had undergone bypass surgery in the past and had suffered multiple heart attacks. The patient was also suffering from kidney failure and diabetes.

Gray and Dowling said the man had been turned down by a heart transplant center and had "an 80 percent chance of dying within 30 days." Gray said it is not possible to say what his life expectancy is today.

"Our hope is that he lives months or years," said Dowling, noting that models of the artificial heart had been running for more than a year.

They said, in time, the man should be able to have an "active" life. Gray said he would not be able to perform athletic activities like jogging, but he should be able to "go shopping."

The new heart is revolutionary in that former artificial hearts had to be powered by external controllers, often weighing as much as 300 pounds. Patients on those units suffered numerous infections, often blamed on the external tubes and tethers that acted as infection pipelines into their bodies. Others suffered from strokes attributed to the operation of the hearts.

The new heart was sewn inside the patient's body along with a battery pack and controller, and has no tubes or wires extending outside his chest.

The implanted battery pack is for short-term use. Dowling said the heart normally is powered by a unit that is "plugged into the wall" and transmits an electrical current through the skin.

If the patient wants to "go to a ball game," he said, there is a battery belt that will power the unit for four hours with each battery.

The man would be able to take a shower or perform other movements away from external power sources by using the battery implanted in his chest, which Dowling said would power the heart for "30 to 40 minutes."

A spokesman for Abiomed, Inc., the company that manufactured the heart, said although the long-term goal is for the artificial heart to keep someone alive for five years, the company's "short-term immediate goal" for this first patient is to live six months on the device.

If the patient lives for two months on the heart, the spokesman said, the company plans to implant the heart into 15 patients. Right now, the patient in Louisville is the first of five patients in the initial round of the clinical trial. Abiomed has not indicated when it plans to implant devices in the other four, or even whether the patients have been selected yet.

The spokesman, who asked not to be named, said the patient and his family were informed that because the device hasn't been tried out in a human before, it's unknown how long it will work.

"For them (the family) it's a gamble," he said. "They have to be courageous and fighters."

With the patient having only a month or so to live with his own heart, "it was a choice between certain death and an unquantified chance for something better," he said.

"The most sincere respect and thanks goes to the patient," said David Lederman, president of Abiomed. "He has been very courageous. He's in the best of hands and what he's done takes a tremendous amount of courage."