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Doctors Address Status of Artificial Heart Patient

Aired August 21, 2001 - 14:03   ET


NATALIE ALLEN, CNN ANCHOR: You're about to meet a true medical pioneer. Robert Tools is the man who received the world's first self- contained artificial heart in July. And he's speaking out publicly today for the very first time.

Doctors said Tools had only a 20 percent chance of surviving one more month if he had not had the surgery.

CNN medical correspondent Rhonda Rowland is standing by at Jewish Hospital in Louisville, Kentucky, where Tools' historic statement is about to begin -- Rhonda.

RHONDA ROWLAND, CNN MEDICAL CORRESPONDENT: Well, we can tell you it's been 51 days since Robert Tools had the AbioCor artificial heart implanted in him.

This, of course, is a battery-operated device, self-contained. It was designed with the intention that the people who receive it would be able to have a good quality of life, be able to resume their everyday activities. We haven't heard many details about how he is doing.

And, of course, until now, we have not heard from the patient. And the doctors said right from the beginning they didn't know when or if we would ever hear from the patient. They have been leaving this decision totally up to the patient for him to decide when he wanted to speak. And last week, we did hear about a little setback with his recovery: that he had to be put back on a ventilator to help him breathe.

And doctors predicted if we would hear from him, it may not be until the end of the month. So it was a bit of a surprise to hear that he would be speaking today. So now we're just standing by again, waiting for him to speak to us -- Natalie.

ALLEN: All right. And we will bring you live coverage of that. Right now we are going to send you to the news conference and provide live coverage of one of the doctors, Dr. Laman Gray, who is talking about Mr. Tools.


DR. LAMAN GRAY, HEART RECIPIENT'S PHYSICIAN: ... respect for the patient and everything. It's been a very eventful five weeks or so. And we'll sort of try to recap what has happened during that time -- and what the patient is -- I know the main thing is, people want to meet our patient. And he wants to meet everybody.

It may interest you to know that Mr. Tools has actually requested the press conference. It's his idea. And he's doing it because he wants to come out and meet everybody and appreciate his thanks for the world's support. I think the first thing we'll do is -- since probably everybody knows pretty much his clinical history and what's happened -- sort of an update in the last week or so, he's been doing very, very well.

And, as you see, he's up walking around. He's really getting his strength back. And I think he'll be able to talk for himself very nicely. One thing, there's sort of been some confusion, and people have not fully understood, are some of the -- basically, the electronics of the device. And we wanted to sort of go over a little bit what happens.

And, Rob, maybe you want to talk about the console?


Some of the things to remember that we talked about before is, the device is totally implanted. But there are certain different components. This is, again, just briefly, what we call the thoracic unit. It pumps blood through the lungs and through the body. OK? And that goes where the heart is. It's put in orthotopic position.

It's hooked together. So Mr. Tools now has this sitting in his chest, as you know from his X ray. And at the same time we implanted the artificial heart, we implanted an internal battery. It will give him 20, 30 minute, maybe 40 minutes of power, and a controller. And if you all remember the old Jarvik, and the controller was as big as a refrigerator. With advances in electronics and so forth, it's down to something that can fit in the palm of your hand, especially if you are a surgeon with nice beautiful hands.


DOWLING: But the battery won't last forever. So we have to have some other way to get energy to the patient. It's a good thing I have those hands.

So also underneath the skin is what we call a primary TET coil. So everything you see here is underneath the skin. This is underneath the skin. He's left-handed. And so we put it on his right side because he is left-handed and we didn't know if it would interfere with his usual left-handed things or not. But we put it on top right side. And on top of that goes a number of other things.

And we brought one of our fellows here today to show you the, what we call the


DOWLING: Oh, you want to show the console?

GRAY: Yes.


So, usually, when a patient is on this device...


DOWLING: In addition, the controller also sends a radio frequency signal to this console every time the heart beats -- actually, not every time the heart beats, but continuously, a number of times a second.

So we, the nurses and the engineers from Abiomed and our perfusionist and so forth here can look at this console and see every time the heart's beating, how it's functioning, not only each beat, but at the beginning of each beat, the middle of each beat, the last third of each beat, the end of each beat, for the left side of the heart and the right side of the heart.

So there is a transmitter that transmits that energy. And we're just going to do a mock setup here...

GRAY: That's right.

DOWLING: ... and show you.

So this is sitting somewhere close to the patient in his bed, maybe a couple feet away. This is the TET coil that is underneath the skin. And this is the TET coil that is on top of the skin. And this technology has worked out fine. There hasn't been any problems. And it drives the hearts and beats it.

And there's a number of modes we can set that on. Dr. Gray and myself, working with the engineers, can adjust the beat rate of this thing, how many times this beats a minute. We can adjust how it balances the left and right side of the heart. Or we can put it on automatic mode, just like our own heart is. None of us have to dial our own heart rate. And this is sophisticated enough that it also, with changes in position, changes with breathing, exercise, the heart rate will adjust.

And not only that, will the heart rate adjust, but the balance between the right and left side of the heart that we all take for granted and most of you never even think about, is also automatic. So there is the total automatic mode.

GRAY: OK, here. Now we're on the battery.

DOWLING: So now Dr. Gray removed the TET coil that was driving energy to power this thing. And now it's on the internal battery. If the internal battery were to run out, then it would stop. Of course, that would never happen. There's all types of alarms and backups and so forth.

And the heart rate starts coming down when the battery runs low. So you have plenty of time and there's plenty of safeguards to prevent that from happening.

So now the TET coil itself can be plugged into the wall if you are just sitting around your hospital bed or you're home watching football, listening to music, whatever you want to do. But if you want to get up and move around, the TET coil can be plugged into what we call the patient-carried electronics.

GRAY: This is Dr. Jeff Boskins (ph), our chief...


DR. KEVIN BRADY: Dr. Kevin Brady (ph).

GRAY: Brady. I'm sorry.


GRAY: Brady.

DOWLING: Kevin is one of our cardiac surgery fellows. And he's been involved in the project from the day of surgery. He has spent many sleepless nights with a lot of our patients, including Mr. Tools.

Early the first night, you remember, he had to go back to surgery and Kevin was there to help take care of him. And, basically, we assigned him to basically live in the hospital for at least the first month of his postoperative care, so -- and, you know, also in terms of nursing recruitment, all of our residents look like this.


DOWLING: So if you could take your jacket off.

So what Kevin has here is the TET coil. Now, he is a little bit shy, so we didn't want to have him shirtless. But this would be underneath his shirt. And instead of going to the wall, it's to a battery pack. And you can wear as many battery backs, depending on how strong you are. Basically, the belt is designed for two battery packs. And it is Velcroed on here. And it's very easy to put on. But it's also very difficult to take off by accident -- so easy on and off on purpose, and hard off by accident.

And there's a little controller here that tells you if there is a problem. In other words, if you are doing something vigorous or someone bumps you during whatever, it will tell you that your TET coil is off. And then you could just say: Well, I want it off because I want to get -- just go on internal battery or you just adjust it.

We've found that it's been very easy to set this TET coil so that it doesn't move. And it was something we learned from our laboratory experience. Also, we'll tell if there's -- if you're on the internal battery, if the internal battery is low. And also, it will tell you if there is a problem with the internal controller. But we haven't seen any problems with the internal controller in our first 50 1/2 days so far.

Anything you want to add to that?

GRAY: That's about it.

DOWLING: So it's relatively -- Steve, bulk, what do these batteries weigh?

UNIDENTIFIED MALE: About two pounds.

DOWLING: Two pounds. And they last -- four?


DOWLING: So -- that's right. You get an hour a pound of batteries. So -- and we just say take twice as many. So if you are going to go to a baseball game that is about three hours long, take extra batteries. Someone with you can carry them in a backpack. Or you can try to rough it out yourself.

GRAY: Great.

DOWLING: OK? Thank you, Kevin.

GRAY: Why don't we -- what we'll plan to do is, Rob and I are going to go down to my office where the patient is. And we'll introduce the patient. And he will probably be willing to answer some questions. And then the two of us will come back up and be able to go over any questions that anybody might have.

Why don't you show the short video?

MODERATOR: While Doctors Gray and Dowling are making their way down to Dr. Gray's office...

ALLEN: The doctors are heading over to the patient now, Robert Tools, the man who has received the world's first self-contained artificial heart.

And you just heard them go over what has been implanted inside this man who has now lived with this device since July 2. They're walking to the office where he. And we'll hear from him in a moment.



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