A patient in the Czech Republic has become the first person in the world to survive for nearly six months without a heart. The patient, a 37-year firefighter, had a malignant tumor that allowed immediate transplantation as the only alternative. When a donor was not found in time, his heart was replaced by two mechanical pumps.
Czech firefighter Jakub Halík was operated on 3rd March knowing he had a year to live or less. Previously, only one other patient, in Texas, underwent similar surgery. That patient did not survive. Halík has now been without a heart for almost half-a-year, still waiting for the appropriate donor. He says that although it was not an easy decision, there was really no other option.
“Definitely, it was a difficult decision… I decided to fight for life and to undergo surgery. I feel great, both physically and emotionally. Actually, I can’t recognize any difference from normal because my body still functions the same way. The only is that now I have no pulse.”
Historically, the first attempts at implanting a mechanical heart date back to World War II and were gradually repeated as technology developed since 1953. The first pumps were outside the body, where the patient was hooked up to apparatus. The first real implant of a heart pump was made in 1968. The pump was used to support the left ventricle of the heart. What made the operation on Jakub Halík unique was the use of two pumps after the heart had been removed. Professor Jan Pirk, who oversaw the operation, explains why the implantation of the two-pump system was necessary:
“The reason is that heart has two sides, the left and the right; it is a two-pump system. If we remove the heart we have to replace it with two artificial pumps. We’ve only left the posterior walls of the left and right atriums in the body. All other parts of the heart were removed.”
According to Professor Pirk, the pumps completely replace the left and right ventricle:
“The left pump sends the blood to aorta, in the body, and the right pump sends the blood in the pulmonary artery and in the lungs. The difference is that the right side system has lower pressure and the left side is a high pressure system. It was very difficult to make it to work with low pressure. We solved the problem within a couple hours.”
The patient since the operation remains in hospital but is mobile and fully active with some limitations: while he can take the stairs, for example, it would not be possible to take part in more strenuous activity. For that he’ll still have to wait for a proper donor. As for the operation and use of the heart blood pumps, termed the HeartMate II, widespread use is generally not expected, as the nature of Mr Halík’s disease is fairly rare: in most other transplant cases a single pump is usually enough. Professor Jan Pirk again:
“I don’t think it will be soon because I hope these malignant tumors are not be very common disease; worldwide, maybe, but not in a single centre.”