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Published: Tuesday, 7/22/2008

Implant restores heart of transplant candidate

ASSOCIATED PRESS
Taneal Wilson, 31, received a pump implant to help him live long enough for a heart transplant. His heart recovered so well doctors removed the pump. No transplant is needed. Taneal Wilson, 31, received a pump implant to help him live long enough for a heart transplant. His heart recovered so well doctors removed the pump. No transplant is needed.
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WASHINGTON - When it comes to hearts, Taneal Wilson won the lottery.

A small pump implanted to keep the 31-year-old alive long enough for a heart transplant somehow helped Mr. Wilson's ravaged heart completely recover instead.

Only a lucky few are ever weaned off those implants, their rested hearts able to work on their own again. How to duplicate those successes is one of cardiology's biggest questions - as a new generation of heart pumps begins U.S. testing.

"Why his heart recovered and the next person's heart does not recover, we don't know," said Dr. Steven Boyce, Mr. Wilson's surgeon at Washington Hospital Center in the nation's capital. "We're waiting for the science to catch up to the art."

That science is beginning. Doctors have begun pairing heart pumps with high doses of cardiac medication in hopes that more aggressive therapy will shrink flabby enlarged hearts enough to avoid a transplant, or at least enable patients to survive longer without one. At a few U.S. and British hospitals, they're testing an experimental steroid-like drug on pump recipients that might spur heart muscle to rebuild.

Experts recently urged testing heart pumps on patients who aren't quite as sick, instead of reserving them for the near-dead like doctors do today.

Heart failure is on the rise, with 5.3 million Americans and 20 million people worldwide whose hearts become weak and unable to pump properly because of age, damage from a heart attack, or other problems. In half of all cases, doctors can't even find a cause - like Mr. Wilson, who went from healthy to near comatose in weeks.

Medications and certain pacemakers help, yet heart failure kills 57,000 Americans a year and contributes to many more deaths. Only about 2,100 patients a year receive a heart transplant. A few thousand more try to buy time with "left ventricular assist devices" that take over the left ventricle's job of pumping blood through the body, powered by special batteries worn in a fanny pack.

But rarely do patients fare as well as Taneal Wilson - whose pump was surgically removed June 17, 10 months after its implant, because his heart is functioning normally again.

"This is a second chance God gave me," he said.

Mr. Wilson was a school maintenance crew supervisor, used to physical labor, when he suddenly found it difficult to breathe. He spent weeks in intensive care before Dr. Boyce implanted the then-experimental HeartMate II, the only LVAD small enough to fit his chest.

Doctors can't yet predict which LVAD recipients will be lucky like Mr. Wilson, although patients with abruptly damaged hearts have a better shot.



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