25-Year-Old Lived for More Than a Year Without a Heart | Hacker News Reader

25-Year-Old Lived for More Than a Year Without a Heart

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53 pointssigna1132 comments

Reminds me about David Foster Wallace's passage from Infinite Jest[0]:

> The 46-year old recipient of the Jarvik IX Exterior Artificial Heart was actively window shopping in Cambridge, Massachusetts' fashionable Harvard Square when a transvestite purse snatcher, a drug addict with a criminal record all too well known to public officials, bizarrely outfitted in a strapless cocktail dress, spike heels, tattered feather boa, and auburn wig, brutally tore the life sustaining purse from the woman's unwitting grasp. The active, alert woman gave chase to the purse snatching 'woman' for as long as she could, plaintively shouting to passers by the words 'Stop her! She stole my heart!' on the fashionable sidewalk crowded with shoppers, reportedly shouting repeatedly, 'She stole my heart, stop her!' In response to her plaintive calls, tragically, misunderstanding shoppers and passers by merely shook their heads at one another, smiling knowingly at what they ignorantly presumed to be yet another alternative lifestyle's relationship gone sour. A duo of Cambridge, Massachusetts, patrolmen, whose names are being withheld from Moment's dogged queries, were publicly heard to passively quip, 'Happens all the time,' as the victimized woman staggered frantically past in the wake of the fleet transvestite, shouting for help with the stolen heart.

[0] Wallace, David Foster. Infinite Jest. New York: Back Bay Books, 10th Anniversary Paperback edition, 1996. Pg 143.

The 'artificial heart in a backpack' device itself: https://syncardia.com/clinicians/home/

I love how that website has a ten step installation guide. Makes it looks like slightly gory IKEA!

You have to hope your surgeon isn't just reviewing these assembly instructions pre-op.

For new devices (even more simple things like a new hernia technique) they will have a rep from the company who can advise the surgeon how the device is used until they are more used to it.

Imagine having your heart in a backpack and some dumb security guard wants to take away your backpack for inspection.

I would hardly leave the house wearing something like that.

No way imagine snagging the tube carrying blood into your body on some door handle and having it ripped out spilling blood everywhere.

The tubes on modern devices carry air; the implanted pumps are pneumatically driven.

The psychological burden must be immense.

My greatest fear would be damaging the backpack or the cables.

This guy is Iron Man.

(I wonder, if this thing fails, does it have a hand crank?)

Edit: The answer is no, you need to find an AC power outlet. If the power is out, you die. How scary.

What a remarkable arrangement a hand crank (or, more robustly, a pair of squeeze bulbs that you could compress in alternating fashion to work around any failure in the whole battery->electronics->motor->pump chain) would be: Reacting oxygen with stored chemical energy in muscles, to move air in some tubes, to push oxygenated blood to those muscles.

Though if it can be charged by AC, you'd better believe I'd keep around a Lipo battery pack and DC-AC inverter, and would be stocking up on deep-cycle batteries, diesel, and a generator or two!

Reacting oxygen with stored chemical energy in muscles, to move air in some tubes, to push oxygenated blood to those muscles.

Oh, oh, I know this one! What is, “Diaphragm”!

It's really interesting to think about, isn't it! It's not perpetual energy, but there's a lot of room for failure in that cycle.

At what point will become better not to trust your 90 year old heart and just use this instead?

25 year old heart vs this machine is no match...but a 90 year old heart which could fail at any moment...maybe the swap is worth it.

that won’t happen for two reasons: at some point the cost of this procedure will exceed the quality and length of life expected and a 90 year won‘t be a candidate for heart transplantation anyway

The only problem with that is that 90 year olds are often not good candidates for any serious surgery. You'll have a better chance with an old (otherwise un-notable) heart than with major heart surgery for a long time.

If your heart is actually failing, fine, but then it has nothing to do with being 90 - you could be 25.

I've known some pretty healthy and active 90 year olds that could benefit. The problem might be, that if the young heart pumps to strongly, thin or weak blood vessels might start too leak under the higher pressure of a young heart. This happens when they give certain drugs to increase blood flow, on a weak heart, but then, for example, the eye blood vessels leak, causing macular degeneration. On the other hand perhaps a heart would be controlled by the body automatically whereas the body can't control a drug dose?

I wonder how much software is in this system? Obviously not much, after looking at HN over the last many years: -Ransomware attack - pay or we turn off your heart pump! -The system will now shut down, ok? Over a whole year of operation seems to be a pretty good test of system hardness.

here is the actual procedure of implantation: https://www.youtube.com/watch?v=mstm_2wlHPc

I wonder how they solved the clotting problem.

That was my first thought too. Clotting and mechanical shredding of red blood cells. These can be problems even over the span of a single operation where bypass is used.

Heavy-duty anticoagulants. Don't have a bleed.

The hemolysis must've been insane. I wonder why ECMO pumps aren't always mechanical baffles or a bulb to be easier on the blood. Just playing drums or a riding a motorcycle can lower your ferritin reserves from nuking RBCs in your hands and arms.

From what I read in the past the lining of the lumens is in some flavour of frictionless material. They also generate faster and continous flows (there is no actual pulsing).

The physical layout will likely be designed to avoid turbulent flow.

Also I am not certain but they will probably put the patients on blood thinners to have some margin.

There's a different doctor that is using turbines to continually move blood. They have special bearings that prevent shredding and clots. Interesting note: a patient with this system will have no detectable pulse!

https://www.popsci.com/science/article/2012-02/no-pulse-how-...

Also, it seems that this doctor was pushing the turbine heart system on patients that didn't actually need it in order to further research.

https://www.houstonchronicle.com/news/investigations/article...

"This 25-Year-Old Lived For More Than a Year Without a Heart

" And the reporter more than a year without a brain.

Given he was able to be active (play basketball), this opens up a path for better optimizing heart transplant supply chain - which I assume would be volatile.

woah, does this mean we can prolong life expectancy by a few years, and potentially longer in the future?

Portable ECMO. Yikes.

Perfusionists typically think ECMO = circling the drain.

If you can survive it, you are basically Iron Man as mentioned elsewhere.

https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygen...

[inside his body]

I agree the title is too spectacular, or clickbaity, but technically speaking, he didn't have a heart. That 6kg backpack thingamajig is just not a heart. It's like calling a wheelchair legs.

Amazing thing, though.

Also, it was in his body. The backpack just powers the implanted pump.

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