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Jim Braid
Artificial Heart Transplant
Jarvic 2000 Permanent Artificial Heart
_________

Jim Braid

In November 2003, 57 year-old Jim Braid became the sixth person in the UK to be given a Jarvik 2000 permanent artificial heart. This is only the second time that such an operation has been performed at Royal Brompton and it was part of a collaborative effort between our Trust and John Radcliffe Hospital, Oxford. 

Professor Philip Poole-Wilson, Professor of Cardiology and Honorary Consultant, is leading the research into lifetime thera­py, together with Cardiac Surgeon Professor John Pepper and Mr. Stephen Westaby, also a Cardiac Surgeon, from John Radcliffe Hospital, Oxford. 

Prof Philip Poole-WilsonProfessor Poole-Wilson has been involved in all six permanent artificial heart procedures in the UK and has had part responsibil­ity for the selection and care of all patients. He explains: "Heart failure is getting more common and is a disease now associated with old age as more people are surviving heart attacks. There have been enormous advances in drug treatment, leading to improved duration and quality of life. Transplants are the stan­dard med­ical treat­ment for those suf­fering with severe heart failure, but today there is a growing shortage of organs and a need to explore alternative meth­ods of treating heart failure. These include, gene therapy, which is experi­mental, cell regen­eration, which is very much at its beginning stages, and the engineer­ing approach; building artificial heart pumps or Left Ventricular Assist Devices (LVADs). This area is far more devel­oped and has been used in the UK, Europe and the US." 

Initially, LVADs were used for bridge to transplant and removed when the transplant took place. Eight Jarvik artificial hearts have been implanted at Harefield Hospital and these were used as bridge to transplants or bridge to recovery. Three years ago, the first Jarvik device was implanted for lifetime treatment at John Radcliffe Hospital, Oxford. 

JarvicProfessor Poole Wilson comments: "The Jarvik is about the size of a thumb, yet it is extremely powerful and performs a remarkable 10,000 revolutions per minute. It takes the blood out of the heart and moves it around the body at a constant speed."

The Journey to JARVIK 2000. Selecting the appropriate patients for lifetime treatment is a complex process and patients need to undergo thorough assessments to establish their eligibility or a permanent artifi­cial heart. They normally present with severe heart failure, have short life-expectancy and are unsuitable for transplantation.

Other key factors taken into consideration are kidney func­tion, age, blood group, intoler­ance to immunological drugs and patient choice. 

Professor Poole-Wilson contin­ues: "Our patient Jim Braid was referred to us from the trans­plant Unit in Scotland where they had concluded that he was unsuitable for transplantation and Jim himself had expressed a wish not to have a transplant. His quality of life had seriously deteriorated - he could no longer walk upstairs and became breathless after a few paces. " 

Jim and his family were briefed in detail on the Jarvik procedure and the impact that it would have on his and his family's life. He was very aware that he would be undergoing pioneer­ing and high-risk surgery. Jim said: "Even if the operation hadn't gone well, I would have been contributing to something positive." 

Due to the highly complex nature of the operation, a 30­strong theatre team was involved, led by Professor Pepper and Stephen Westaby. As the Jarvic 2000 also involves some intricate work on the skull, Ear, Nose and Throat Surgeon, Mr. Andrew Freeland, from University College Hospital, also played a vital role.

Prof Pepper

Professor Pepper commented: "The operation was very successful. Mr. Braid is recover­ing well and we look forward to monitoring his progress. This procedure is extremely difficult to co-ordinate and we are very grateful to the multi-disciplinary team members involved who all contributed to the success of the operation," 

Hayley Price-Hawkins, Heart Failure Support Sister explains: "Our role is crucial in the man­agement of care for artificial heart patients. We provide edu­cation, much needed support and will liaise with relevant individuals on the patient's behalf, We work to try and keep patients at home so they don't need hospital admission so frequently. Now that Jim has had the operation, we are working on how to get him living back at home as quickly as possible. We have already spoken to his family, his GP, and the local ambulance service to ensure that everyone is fully aware of his requirements. Mandy Hipkin, LVAD Nurse Specialist, will be liaising regularly with Jim and his family about home care and the technical aspects of the Jarvik."

Professor Poole-Wilson concludes: "This area of medicine is hugely com­plicated and needs courage and skills. We want to demonstrate the efficiency of the artificial heart devices before they become widely used, There are plans to conduct large clinical trials in the UK and pos­sibly at European centres. It is essen­tial for us to develop collaborations between surgeons and physicians in the UK to enable a UK study, of which a very large part will be con­ducted at our Trust," 

After being with us for nearly two months, Jim can now look forward to spending a special Christmas in his native Scotland: "I have been in and out of hospital all year, sometimes not knowing whether I would see my home again. I am so glad that I have been given the Jarvik and the opportunity to live. I am over the moon at the prospect of spending Christmas with my family in Scotland and am so grateful for the encour­agement, support and wonderful care of the entire medical team."



Christiaan Barnard
Christiaan Barnard

"For a dying man, a transplant is not a difficult decision. If a lion chases you to a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side. But you would never accept such odds if there were no lion."

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