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An artificial heart that beats almost exactly like the real thing is to be implanted in patients within three years in a trial that may offer hope to heart disease sufferers unable to receive a transplant.
The device, which uses electronic sensors to regulate the heart rate and blood flow, was developed by Alain Carpentier, France's leading cardiac surgeon, and engineers from the group that makes Airbus aircraft. Presented yesterday, it was described by its inventors as the closest thing yet to the human heart. “If you show the graphs to a cardiac surgeon, he will say it's a human heart,” Professor Carpentier said. “But no, it’s not a human heart, it’s the prosthesis.”
He said that he had spent two decades on the project because “I found it intolerable to see young people - aged 40, 45 or 50 - dying of massive heart attacks without having a prosthesis available to replace their hearts”.
The French announcement is the latest in a race by doctors to produce a device that could be fitted into the 20,000 patients a year worldwide who are unable to receive a life-saving heart transplant because of a shortage of donors.
Two artificial hearts have been invented in the US, the Jarvik 7 and the AbioCor, but both have drawbacks, according to Professor Carpentier’s team: the first has wires that protrude through the skin, and the second can produce blood clots that can lead to strokes, they said.
Carmat, the company founded by Professor Carpentier and EADS, Europe’s aerospace and defence giant, says that it is close to overcoming these hurdles. Sensors in the artificial heart will automatically regulate the heart beat, detecting the body’s needs: increasing the rhythm when patients are walking, for instance, and slowing it when they are resting.
“If you get up in the middle of the night to go to the loo, you need the artificial heart to know immediately or you’ll collapse on the floor,” said Philippe Pouletty, an immunologist whose private equity firm, Truffle Capital, has invested €5 million (£4 million) in the project.
Professor Carpentier said that he had reduced the risk of clots by creating the heart with a “pseudo-skin” of biosynthetic, microporous materials. “This has been the essential problem until now,” he said.
Two options are under study for the power supply, which remains a significant hurdle. One involves implanting a titanium receiver in the skull that would channel energy sent through the skin - without piercing it - from a battery outside the body to the heart. The second would work by a similar method: getting electricity through the skin between two transformers, one inside and one outside the body. Carmat says the battery could last for between 5 and 16 hours, after which it would have to be recharged to prevent the artificial heart stopping.
The artificial heart has been tested successfully on calves and sheep, according to Professor Carpentier, and will be implanted in patients with terminal heart failure for a clinical trial in two or three years’ time. If that is successful - and if Carmat can find about €100 million in funding - the French artificial heart will be available as an alternative to transplant in 2013.
“These are tremendous advances,” said Leslie Hamilton, consultant cardiac surgeon at Freeman Hospital in Newcastle upon Tyne. “Transplantation is limited to a fixed number of patients. But for artificial hearts, the sky’s the limit.” He added that the French device needed to undergo trials before it could be used in hospitals, which may take many years.
Smart heart
As the artificial heart’s motors compress the left chamber and open the right one, oxygen-rich blood from the left chamber is pumped out into the body and blood lacking in oxygen fills the right chamber.
The left chamber is then opened while the right chamber is compressed, pumping the deoxygenated blood from the right chamber back to the lungs and drawing a fresh supply of oxygen-rich blood from the lungs into the left chamber.
Unlike previous artificial hearts, this one detects the body’s activity level (and therefore how much oxygen it requires) and changes its pace accordingly
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