Carmat a French company has a total heart product for a while in Europe. In February they celebrated the 100 implants, with the longest one lasting 25 month. https://www.carmatsa.com/en/our_product/
However this is really difficult and the company is struggling financially as the market is rather limited.
Really sucks a company doing something important like this is struggling. Such kind of company shouldn't need to worry about profits because we know how profit-minded medical breakthroughs look like.
> When do we say, it‘s enough, your condition is not compatible with life, enjoy some palliative treatment?
When it doesn’t affect you, obviously.
Maybe if some billionaire had 5 less jets, we could push medicine a little bit further and save more lives for the benefit of humanity.
It's research like this that throughout the ages has led our life expectancy to grow as much as it has. We are just tackling more and more niche areas because we have solved a lot of the easy stuff.
Yes, its called a developed society and compassion for a fellow less fortunate man. Christianity for example has this at its absolute core, as do all other religions. But since I saw first hand how US population in general sees and treats homeless and those with mental issues, I dont think the message gets through.
Whole (not only) western world can make such system work for a fraction of US healthcare costs, why shouldnt US?
Maybe in 5 years after some health issue or accident you will end up on sone lifelong treatment, then you may reconsider how others will help you survive.
It's not true at all. A cardioplegia solution is injected into the heart itself to arrest the heartbeat, and to protect it from tissue damage while awaiting transplantation. But this is done after the donor's chest has already been surgically opened, and has nothing at all to do with "paralyzing" them or preventing them from struggling. If they were going to struggle, surely they would do so when the operation started! But no such paralysis is needed, of course, because the donor has already been determined to be brain-dead by that point.
As an interesting note, even the basic premise of the preceding comment is not accurate. A small but increasing number of heart transplants are performed as DCD operations, which means the donor's heart stops naturally on its own before being removed: https://www.acc.org/Latest-in-Cardiology/Articles/2022/11/21...
sorry, so the heart is still beating in the dead donor? The doctors harvesting the heart stops the donors heart from beating? I have to be missing something here. You cannot be saying that doctors stop the donors heart from beating (kill them) before taking the heart.
As poster above you states, they are clinically dead at the point the heart is removed. Their brain has stopped functioning. There is no coming back. They are a meat popsicle.
If you’re a heart donor, you have been diagnosed as “brain dead”. This means that even though your heart is still beating and you’re drawing breath, your ECG is a flatline, and there is no hope of recovery (with our current medical technology)
That means that your grieving next of kin have decided (for you, since you no longer have conscious thoughts) that your last act on this planet will be an act of kindness. You will give your heart, lungs, eyes, etc to someone that can still make use of them. The last thing you will do, is saving the life of someone.
So yes, they (directly or indirectly) stop the heart.
That’s a good question!
As a layman I would assume there’s no way to read/detect the hormones that would demand acceleration of the heartbeat? So one has to take it easy for the rest of their life? Or maybe there’s a way to manipulate it manually?
If the heart is no longer the weak link, can you permanently increase level of blood flow to something akin to moderate exertion? Presumably you are now limited by what the veins can handle, but maybe they have more flexible performance characteristics?
Layman, but I imagine if your blood is flowing to fast doesn't help much the lungs have certain diffusion rates, the waste products wouldn't be increased because your not doing as much work. There is probably an optimal point where anymore just doesn't really matter.
I beat there is some psychological factors to thought you don't have a beat or pulse that is probably unsettling
My friend had this pump pack attached to him (the same thing Dick Cheney had) and it was constant flow. His heart technically worked but it was so weak you could barely detect it. The pump was just constant circulation, no pumping.
It used to be assumed to be the case because the heartbeat is so closely associated with life. This is why the first artificial hearts replicated pulses, despite requiring much more complexity. It turns out that your body can function more or less fine with continuous blood flow.
They technically worked but they were expensive, painful, and basically just kept you alive on a bed. In essence they were like a more invasive version of the iron lung but required a team to maintain.
For this reason while you may have heard it used it various trials with "success" they were considered a failure in the end and rejected by the FDA. I've spoken to some people who worked on it and the feelings are pretty bittersweet.
Learning from this, Abiomed later brought a heart pump called the "Impella" to market which works to assist your heart instead of replace it. This device is cool for different reasons and can actually save peoples lives instead of merely prolong them a few years.
The new artificial heart in the OP is more sophisticated than the AbioCor, the science keeps improving.
The Jarvik-7 artificial heart was first implanted in a human patient in 1982. But those early designs were bulky, required external power sources, and were more of a temporary measure
A very interesting tour is the small museums at Baylor College of Medicine and Texas Heart Institute. They were literally making replacement parts on a sewing machine 60 years ago. (On the other hand, they let one of those surgeons practice too far long and he left a sponge in my grandfather during an angioplasty. He was ultimately reopened and cleaned out and died of something else a few years later)
My guess is that they put it in some kind of rubbery enclosure before installing it, but who knows? Maybe it's not actually a problem to have hard edges.
Looks like the device is powered by a battery carried by the patient that is connected through what is called a ‘driveline’ basically a wire coming out of your belly connecting to the heart. Really amazing stuff here, especially considering failure of the heart is THE most common cause of death in human beings. One day getting an artificial heart at an old age may be as common as a teenager getting braces.
https://www.monash.edu/news/articles/monash,-bivacor-led-con...
Oh man, you gave me goosebumps just thinking about that episode. That is one of the best episodes [1] of any sci-fi, ever, IMO. That episode changed my entire life perspective.
Looking at the writer's Wiki [2], he was also behind some amazing DS9 episodes like House of Quark and Rules of engagement. Gah, what happened to sci-fi? Turns out he was even the head guy on For All Mankind. Nobel Prize effect, studio pressure, what is it?
How much power does the heart need to pump the liquid and what is it's life expectancy? Any technical specifications for a product that can work in the human body?
Biology, and by extension medicine, only started to look like engineering in the last ~50 years because it requires serious advancements from many other fields of science. As in, you can't discover cells if you haven't invented a microscope yet. It's literally reverse engineering alien technology, in the sense that it's something that wasn't created by humans. And you can't really reverse engineer something when you don't have any tools to meaningfully interact with it and pick it apart.
I disagree - if you move fast and break things then people die. The human body is not a single well-understood system; everyone is different in subtle ways, which incidentally is why personalised medicine is becoming a thing.
It definitely feels that way, especially compared to fields like computing where progress is exponential. But with medicine, the stakes are so much higher... Every breakthrough has to go through years of testing, trials, and regulatory hurdles to make sure it's actually safe and effective
I imagine the slow link is that you have to actually test stuff in the real world, on people. Who in this case could very easily die if it doesn’t work. Isn’t like programming where you can just keep whacking it until it works.
The question I have is why they they die if it doesn't work. Imagine how much faster we could progress if people didn't when an experiment failed. But how could we even accomplish such a thing? Telemetrics to catch issues early, and redundancy to hold the patient over until the issue can be found and corrected?
In this case, two separate mechanical hearts built on different principles hoping they would have different failure modes? Would it even be possible to hook that up correctly? Just brainstorming.
Its even worse than you think, there are complex and numerous requirement hoops you need to jump through for medical software and hardware. It is not easy.
This is an incredible milestone! And not just for the patient, but for the future of heart failure treatment. The fact that someone was able to walk out of the hospital and live with a fully artificial heart for over 100 days is mind-blowing. Still a long way to go before these could replace transplants entirely, but the progress is undeniable
> The patient, who declined to be identified, was discharged from the hospital with the implant in February. A donor heart became available to be transplanted in March.
I've worked in this industry (LVADS and artificial hearts) and met Dr. Timms personally several times.
He and his team have been working on this for decades. It's real, and good stuff.
Congratulations to the whole team, this is the culmination of decades of effort from thousands of people.
Well done
Carmat a French company has a total heart product for a while in Europe. In February they celebrated the 100 implants, with the longest one lasting 25 month. https://www.carmatsa.com/en/our_product/
However this is really difficult and the company is struggling financially as the market is rather limited.
Really sucks a company doing something important like this is struggling. Such kind of company shouldn't need to worry about profits because we know how profit-minded medical breakthroughs look like.
Easy to say, but who SHOULD pay for this, lenmeldy or zolgensma?
(Compared to those treatments an artificial heart is cheap.)
Those easily cost more than the average human earns in their life.
Should the public be financially burdened by outrageously expensive research and treatments for rare diseases?
When do we say, it‘s enough, your condition is not compatible with life, enjoy some palliative treatment?
> When do we say, it‘s enough, your condition is not compatible with life, enjoy some palliative treatment?
When it doesn’t affect you, obviously. Maybe if some billionaire had 5 less jets, we could push medicine a little bit further and save more lives for the benefit of humanity.
It's research like this that throughout the ages has led our life expectancy to grow as much as it has. We are just tackling more and more niche areas because we have solved a lot of the easy stuff.
It's like computers, but more life threatening :)
> Should the public be financially burdened by outrageously expensive research and treatments for rare diseases?
Yes, precisely because they are rare and thus market forces will fail to provide a treatment.
> When do we say, it‘s enough, your condition is not compatible with life, enjoy some palliative treatment?
That will vary case by case, depending on how much the public votes in favor of socialized care vs the suffering of these people.
Yes, its called a developed society and compassion for a fellow less fortunate man. Christianity for example has this at its absolute core, as do all other religions. But since I saw first hand how US population in general sees and treats homeless and those with mental issues, I dont think the message gets through.
Whole (not only) western world can make such system work for a fraction of US healthcare costs, why shouldnt US?
Maybe in 5 years after some health issue or accident you will end up on sone lifelong treatment, then you may reconsider how others will help you survive.
> Those easily cost more than the average human earns in their life.
For this, we have insurance - to distribute the chance of utterly bad luck across all in society.
2016: Successful heart transplant after 1374 days living with a total artificial heart
https://pubmed.ncbi.nlm.nih.gov/26819291/
Let's hope this improves rapidly every year and can become a convenient, inexpensive temporary replacement in a few decades.
I wonder what the progress curve will look like.
This time it's 100 days, next year will it be 110 or 200? I wonder what the shape of the curve is?
It's longer than 100 days already in their preclinical testing but they took it out because the patient found a heart transplant.
They say one upcoming improvement is wireless power via skin, somehow. At the moment the rechargeable battery lasts for five hours.
Sounds kinda scary. So if the battery goes flat or gets disconnected you just immediately die?
These devices have double batteries, external power, and will beep like crazy already quite a while before it runs flat.
I mean, if this didn't exist you'd just immediately die a lot sooner. So I think it's a fair trade-off.
closest thing to the arc reactor in the iron man movie...
[flagged]
Source? This seems hard to believe and google isn't pulling anything like it up.
It's not true at all. A cardioplegia solution is injected into the heart itself to arrest the heartbeat, and to protect it from tissue damage while awaiting transplantation. But this is done after the donor's chest has already been surgically opened, and has nothing at all to do with "paralyzing" them or preventing them from struggling. If they were going to struggle, surely they would do so when the operation started! But no such paralysis is needed, of course, because the donor has already been determined to be brain-dead by that point.
As an interesting note, even the basic premise of the preceding comment is not accurate. A small but increasing number of heart transplants are performed as DCD operations, which means the donor's heart stops naturally on its own before being removed: https://www.acc.org/Latest-in-Cardiology/Articles/2022/11/21...
sorry, so the heart is still beating in the dead donor? The doctors harvesting the heart stops the donors heart from beating? I have to be missing something here. You cannot be saying that doctors stop the donors heart from beating (kill them) before taking the heart.
As poster above you states, they are clinically dead at the point the heart is removed. Their brain has stopped functioning. There is no coming back. They are a meat popsicle.
If you’re a heart donor, you have been diagnosed as “brain dead”. This means that even though your heart is still beating and you’re drawing breath, your ECG is a flatline, and there is no hope of recovery (with our current medical technology)
That means that your grieving next of kin have decided (for you, since you no longer have conscious thoughts) that your last act on this planet will be an act of kindness. You will give your heart, lungs, eyes, etc to someone that can still make use of them. The last thing you will do, is saving the life of someone.
So yes, they (directly or indirectly) stop the heart.
And that is a good thing.
A stopped heart doesn't necessarily mean a person's dead, a beating heart doesn't mean their alive.
Sounds like an offshoot of one of those Death Panel conspiracy theories
How does the device regulate the heartbeat speed? I mean, how does it know that it needs to pump blood faster or slower?
That’s a good question! As a layman I would assume there’s no way to read/detect the hormones that would demand acceleration of the heartbeat? So one has to take it easy for the rest of their life? Or maybe there’s a way to manipulate it manually?
If the heart is no longer the weak link, can you permanently increase level of blood flow to something akin to moderate exertion? Presumably you are now limited by what the veins can handle, but maybe they have more flexible performance characteristics?
Layman, but I imagine if your blood is flowing to fast doesn't help much the lungs have certain diffusion rates, the waste products wouldn't be increased because your not doing as much work. There is probably an optimal point where anymore just doesn't really matter.
I beat there is some psychological factors to thought you don't have a beat or pulse that is probably unsettling
IIRC this problem affects heart transplants as the nerve that controls the speed of the heart is severed during the operation.
Blood oxygen sensors seem relatively cheap and low power.
I wonder if they could use that as the feedback mechanism.
Ideally if the sensors are small, low power, and cheap enough CO2 and lactic acid levels would also be good to check on to increase bloodflow.
It doesn't, neither do lvads
Accelerometers to measure physical activity?
My friend had this pump pack attached to him (the same thing Dick Cheney had) and it was constant flow. His heart technically worked but it was so weak you could barely detect it. The pump was just constant circulation, no pumping.
Hmm, do body processes depend on the fact that blood flows in pulses, and an optimal heart must be pulsed?
It used to be assumed to be the case because the heartbeat is so closely associated with life. This is why the first artificial hearts replicated pulses, despite requiring much more complexity. It turns out that your body can function more or less fine with continuous blood flow.
Yes, with this device, there is no pulse.
I could have sworn there were artificial hearts in the 1980s, or at least news stories about them
Probably this: https://en.m.wikipedia.org/wiki/AbioCor
They technically worked but they were expensive, painful, and basically just kept you alive on a bed. In essence they were like a more invasive version of the iron lung but required a team to maintain.
For this reason while you may have heard it used it various trials with "success" they were considered a failure in the end and rejected by the FDA. I've spoken to some people who worked on it and the feelings are pretty bittersweet.
Learning from this, Abiomed later brought a heart pump called the "Impella" to market which works to assist your heart instead of replace it. This device is cool for different reasons and can actually save peoples lives instead of merely prolong them a few years.
The new artificial heart in the OP is more sophisticated than the AbioCor, the science keeps improving.
The Jarvik-7 artificial heart was first implanted in a human patient in 1982. But those early designs were bulky, required external power sources, and were more of a temporary measure
A very interesting tour is the small museums at Baylor College of Medicine and Texas Heart Institute. They were literally making replacement parts on a sewing machine 60 years ago. (On the other hand, they let one of those surgeons practice too far long and he left a sponge in my grandfather during an angioplasty. He was ultimately reopened and cleaned out and died of something else a few years later)
I wasn't expecting that steampunk look.
I know it's crazy. Looks like a car part.
It is kinda cool looking. But if people can see it in your chest you are doing it wrong.
My guess is that they put it in some kind of rubbery enclosure before installing it, but who knows? Maybe it's not actually a problem to have hard edges.
Looks like the device is powered by a battery carried by the patient that is connected through what is called a ‘driveline’ basically a wire coming out of your belly connecting to the heart. Really amazing stuff here, especially considering failure of the heart is THE most common cause of death in human beings. One day getting an artificial heart at an old age may be as common as a teenager getting braces. https://www.monash.edu/news/articles/monash,-bivacor-led-con...
Just avoid getting into any bar brawls with Nausicaans.
(https://memory-alpha.fandom.com/wiki/Tapestry_(episode) although, the point of the episode was, in hindsight, the fight was the correct move)
Oh man, you gave me goosebumps just thinking about that episode. That is one of the best episodes [1] of any sci-fi, ever, IMO. That episode changed my entire life perspective.
Looking at the writer's Wiki [2], he was also behind some amazing DS9 episodes like House of Quark and Rules of engagement. Gah, what happened to sci-fi? Turns out he was even the head guy on For All Mankind. Nobel Prize effect, studio pressure, what is it?
[1] - https://ww1.goojara.to/eGJakb
[2] - https://en.wikipedia.org/wiki/Ronald_D._Moore
Don't neglect your payments and fall afoul of the Repo-Men either. :P
How much power does the heart need to pump the liquid and what is it's life expectancy? Any technical specifications for a product that can work in the human body?
Crazy how slow medicine progresses compared to technology.
Biology, and by extension medicine, only started to look like engineering in the last ~50 years because it requires serious advancements from many other fields of science. As in, you can't discover cells if you haven't invented a microscope yet. It's literally reverse engineering alien technology, in the sense that it's something that wasn't created by humans. And you can't really reverse engineer something when you don't have any tools to meaningfully interact with it and pick it apart.
I disagree - if you move fast and break things then people die. The human body is not a single well-understood system; everyone is different in subtle ways, which incidentally is why personalised medicine is becoming a thing.
It definitely feels that way, especially compared to fields like computing where progress is exponential. But with medicine, the stakes are so much higher... Every breakthrough has to go through years of testing, trials, and regulatory hurdles to make sure it's actually safe and effective
I hope it dramatically speeds up as AI improves. ASI is likely only scalable route to solving the medical issues that plague humanity.
I imagine the slow link is that you have to actually test stuff in the real world, on people. Who in this case could very easily die if it doesn’t work. Isn’t like programming where you can just keep whacking it until it works.
The question I have is why they they die if it doesn't work. Imagine how much faster we could progress if people didn't when an experiment failed. But how could we even accomplish such a thing? Telemetrics to catch issues early, and redundancy to hold the patient over until the issue can be found and corrected?
In this case, two separate mechanical hearts built on different principles hoping they would have different failure modes? Would it even be possible to hook that up correctly? Just brainstorming.
Its even worse than you think, there are complex and numerous requirement hoops you need to jump through for medical software and hardware. It is not easy.
Wait I thought that was blockchain
Only to die at the stroke of midnight on the 101st day
This is an incredible milestone! And not just for the patient, but for the future of heart failure treatment. The fact that someone was able to walk out of the hospital and live with a fully artificial heart for over 100 days is mind-blowing. Still a long way to go before these could replace transplants entirely, but the progress is undeniable
> The patient, who declined to be identified, was discharged from the hospital with the implant in February. A donor heart became available to be transplanted in March.
This doesn't add up to 100 days.
Hospital discharge != implant
OH that makes a lot of sense thanks for explaining.