Artificial Hearts: The Allure and Ambivalence of a Controversial Medical Technology

373 Pages·2018·63.37 MB·English

by  Shelley McKellar

Artificial Hearts
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Artificial Hearts
The Allure and Ambivalence of a Controversial Medical Technology
Shelley McKellar
Johns Hopkins University Press
Baltimore
© 2018 Johns Hopkins University Press
All rights reserved. Published 2018
Printed in the United States of Amer i ca on acid- free paper
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Library of Congress Cataloging- in- Publication Data
Names: McKellar, Shelley, author.
Title: Artificial hearts : the allure and ambivalence of a controversial medical technology /
Shelley McKellar.
Description: Baltimore, Mary land : Johns Hopkins University Press, 2017. | Includes
bibliographical references and index.
Identifiers: LCCN 2017008834 | ISBN 9781421423555 (hardcover : alk. paper) |
ISBN 9781421423562 (electronic) | ISBN 1421423553 (hardcover : alk. paper) |
ISBN 1421423561 (electronic)
Subjects: | MESH: Heart, Artificial— history | History, 20th C entury | History,
21st  Century | United States
Classification: LCC RD598.35.A78 | NLM WG 11 AA1 | DDC 617.4/120592— dc23
LC rec ord available at https:// lccn . loc . gov / 2017008834
A cata log rec ord for this book is available from the British Library.
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Johns Hopkins University Press uses environmentally friendly book materials,
including recycled text paper that is composed of at least 30  percent post- consumer
waste, whenever pos si ble.
contents
List of Illustrations and T ables vii
Acknowl edgments ix
Introduction. Fighting Heart Disease with Machines and Devices 1
1 Multiple Approaches to Building Artificial Hearts: Technological Optimism
and Po liti cal Support in the Early Years 29
2 Dispute and Disappointment: Heart Transplantation and Total Artificial
Heart Implant Cases in the 1960s 60
3 Technology and Risk: Nuclear- Powered Artificial Hearts and Medical
Device Regulation 95
4 Media Spotlight: The Utah Total Artificial Heart and the Charge
of Bioethics 123
5 Clinical and Commercial Rewards: Ventricular Assist Devices 180
6 Securing a Place: Therapeutic Clout and Second- Generation VADs 211
7 Artificial Hearts for the Twenty- First Century 240
Abbreviations 267
Notes 269
Index 339
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illustrations and tables
plates Color illustrations follow page 130
1. A woman’s body with superimposed replaceable organs and tissues, 1965.
2. Six air- driven devices designed to replace or assist damaged hearts, u nder
development during the early to mid 1960s.
3. Eight experimental total artificial hearts, dating from 1957 to 1981.
4. Life magazine cover featuring the feud between Houston surgeons Michael
DeBakey and Denton Cooley, April 1970.
5. Life magazine cover displaying the Jarvik-7 total artificial heart,
September 1981.
6. Willebrordus Meuffels, in the operating room, implanted with an Akutsu III
total artificial heart, September 1981.
7. Dr. Tetsuzo Akutsu and the Akutsu III total artificial heart, September 1981.
8. Newsweek magazine cover showing the AbioCor total artificial heart, June 2001.
figures
The placement of a total artificial heart in the body. 3
The placement of a left ventricular assist device in the body. 4
Drs. Willem Kolff and Tetsuzo Akutsu examine their experimental mechanical
heart, 1957. 34
Dr. Michael DeBakey and President Lyndon B. Johnson, 1964. 44
Dr. Adrian Kantrowitz and his brother Arthur examine their “booster heart”
device, 1966. 50
Dr. Michael DeBakey and pump implant patient Esperanza Del Valle
Vasquez, 1966. 53
Drs. Christiaan Barnard, Michael DeBakey, and Adrian Kantrowitz discuss the
challenges of heart transplantation, 1967. 70
The Liotta- Cooley artificial heart, 1969. 77
Drs. Denton Cooley and Domingo Liotta with artificial heart recipient Haskell
Karp, 1969. 78
Dr. Denton Cooley at a press conference, 1969. 88
Dr. Norman Shumway speaks to journalists, 1968. 89
Drs. Willem Kolff and Denton Cooley admire the Liotta- Cooley artificial heart,
about mid-1970s. 93
Schematic diagram of the Atomic Energy Commission nuclear- powered
heart. 103
Illustration of a nuclear- powered heart- assist device, sponsored by the National
Heart and Lung Institute, positioned in a calf. 104
Dr. Willem Kolff, standing next to a display of artificial hearts developed in his
laboratory. 127
viii Illustrations and Tables
Drs. Don B. Olsen, Willem Kolff, and Robert Jarvik, posing with two Jarvik-7
artificial hearts. 131
Dr. William DeVries, holding a Jarvik-7 artificial heart next to a model of the
human heart. 139
Artificial heart recipient Barney Clark with his wife Una Loy, December 1982. 142
William Schroeder’s diseased heart is placed on a tray next to a sterilized Jarvik-7
artificial heart, November 25, 1984. 149
Artificial heart recipient William Schroeder visits his hometown of Jasper, Indiana,
August 4, 1985. 150
Artificial heart recipient Michael Drummond with Dr. Jack Copeland and others
at Tucson’s University of Arizona Medical Center, 1985. 157
Dr. William S. Pierce, holding a paracorporeal ventricular assist device developed
at the Pennsylvania State University College of Medicine. 186
Dr. Peer Portner talks to the press about the Novacor left ventricular assist
system, 2001. 193
Former vice president Dick Cheney holds up the battery and control unit of his
implanted HeartMate II left ventricular assist device, September 2011. 212
Drs. Richard Wampler and O. H. Frazier with Hemopump patient Herb Kranich,
April 1988. 223
The HeartMate XVE Left Ventricular Assist System and the HeartMate II Left
Ventricular Assist Device. 225
The Jarvik 2000 Ventricular Assist Device. 229
Dr. Gerson Rosenberg, holding the Penn State Electric Total Artificial Heart. 242
The AbioCor implantable replacement heart. 244
Artificial heart recipient Robert Tools with Dr. Robert Dowling, July 31, 2001. 247
Artificial heart recipient Tom Christerson with Drs. Laman Gray and Robert
Dowling, March 12, 2002. 248
The SynCardia temporary Total Artificial Heart. 255
tables
5.1. Selected pulsatile VADs and FDA regulatory status. 196
6.1. Selected continuous-fl ow VADs and FDA regulatory status. 231
7.1. Selected total artificial hearts and FDA regulatory status. 254
acknowle dgments
This book reflects my interest in medical artifacts and exploring history through
objects. The “ things” of the past have always intrigued me. I like to won der about
and h andle objects, speculating about their use and owner ship, as an access point to
better understand p eople and their practices in the past. Anyone privileged to visit
the Smithsonian Institution’s collection storage areas knows that t here is no shortage
of medical artifacts to inspire a research proj ect. Artificial hearts, however, are a real
showstopper. The mechanical hearts implanted in Haskell Karp (1969), Murray
Haydon (1985), Michael Drummond (1985), and Robert Tools (2001) are among the
more popu lar artifacts at the Smithsonian’s National Museum of American History,
which h ouses an impressive cardiac device collection. I, too, was drawn to t hese
objects— enthralled with the design and construction of t hese devices, amazed that
such technology might work, and a bit awestruck to be h andling the a ctual artificial
hearts once implanted in patients.
I was introduced to artificial hearts through Proj ect Bionics, a collaborative his-
tory proj ect of the American Society for Artificial Internal Organs, the National
Library of Medicine at the National Institutes of Health, and the Smithsonian In-
stitution’s National Museum of American History, which was initiated in 2000 to
document and preserve the rich history of the development of artificial organs. For-
merly in real danger of becoming lost from the historical rec ord, the papers, devices,
and recollections of many artificial organ pioneers are now safeguarded in national
repositories b ecause of this proj ect. I am indebted to Ramunas (Ray) Kondratas,
Robert (Bob) Bartlett and Jean Kantrowitz for selecting a Canadian historian with
a new PhD to participate in this proj ect in its early years. I greatly enjoyed being
part of this documentary history proj ect; it was a wonderful opportunity to capture
the history of artificial organs from the involved participants, researchers, and clini-
cians, and I came to appreciate and re spect the commitment, ability, and compassion
of many individuals working in the field. For the many personal conversations, lab
visits, and proj ect activities, I thank the Proj ect Bionics Working Group (circa 2000–
2005) of Bob Bartlett, Judy Chelnick, Arthur Ciarkowski, Walter Dembitsky, Brack
Hattler, Jean Kantrowitz, Ray Kondratas, Mark Kurusz, Paul Malchesky, Don B.
Olsen, George Pantalos, Steven Phillips, Peer Portner, W. Gerald Rainer, Wayne
Richenbacher, Gerson Rosenberg, Paul Theerman, and John Watson. The energy
and passion of Bob and Jean in leading this successful proj ect cannot be overstated;
both of you are truly remarkable and I learned much from each of you.
I also thank other members of the American Society for Artificial Internal Organs
who kindly took time to speak with me at vari ous scientific meetings. I s hall never
forget the meeting of the society at which I met artificial organs pioneer Willem Kolff,
then in his 90s, who asked if I was “that lady interested in history.” A fter I nodded,
Dr. Kolff smiled and, with both hands, flung open his suit jacket to show me his most
recent device prototype— a wearable artificial lung— and proceeded to tell me how it