First permanent implant of the Jarvik 2000 Heart

Background Heart failure is a major public-health concern. Quality and dura tion of life on maximum medical therapy are poor. The availability of donor hearts is severely limited, therefore an alternative approach is necessary . We have explored the use of a new type of left-ventricular assist device intended as a long-term solution to end-stage heart failure. Methods As part of a prospective clinical trial, we implanted the first per manent Jarvik 2000 Heart-an intraventricular device with an innovative powe r delivery system-into a 61-year-old man (New York Heart Association functi onal class IV) with dilated cardiomyopathy. We assessed the effect of this left-ventricular assist device on both native heart function and the sympto ms and systemic characteristics of heart failure. Findings The Jarvik 2000 Heart sustained the patient's circulation, and was practical and user-friendly. After 6 weeks, exercise tolerance, myocardial function, and endorgan function improved. Symptoms of heart failure have r esolved, and continuous decreased pulse-pressure perfusion has had no adver se effects in the short term. There has been no significant haemolysis and no device-related complications. The skull-mounted pedestal is unobtrusive and has healed well. Conclusions The initial success of this procedure raises the possibility of a new treatment for end-stage heart failure. In the longer term, its role will be determined by mechanical reliability.