Utah and the Artificial Heart
Impact and Reflections Forty Years Later
December 2, 1982…
A snowstorm raged outside of the University of Utah Medical Center as Doctor Barney Clark was wheeled into the operating room. He was fading fast from end-stage cardiomyopathy and was scheduled for a historic surgical intervention- the first-ever permanent artificial heart implant.
In the late 20th century, heart transplants were still a recent development. In 1982 only 45-50 heart transplants were performed in the United States. Medical practitioners and researchers recognized that advancements were necessary. Heart disease was growing increasingly common, and approximately one-third of eligible patients died before a heart became available. Realizing that supply would always outweigh demand, researchers at the University of Utah hoped that artificial hearts would resolve that discrepancy.
Dr. Willem Kolff began the Department of Artificial Organs at the University of Utah in 1967 and immediately began research and development on the artificial heart. Over fifteen years, countless researchers, doctors, nurses, veterinarians, students, and lab assistants assisted with the project.
Dr. Willem Kolff
Dr. Kolff is considered “the father of artificial organs.” An immigrant from Holland, Dr. Kolff is well known for inventing dialysis using an artificial kidney and for his work with artificial hearts.
Dr. William DeVries
Dr. William DeVries was an Utah native who led the surgery on Dr. Barney Clark. He was the only surgeon who the FDA approved to conduct the implant.
Dr. Robert Jarvik
Dr. Robert Jarvik was the principal designer for the Jarvik-7, the artificial heart model used in the surgery. He modified models that Kolff and other researchers had been developing for many years.
Dr. Don Olsen
Dr. Don Olsen was the head veterinarian for the Department of Artificial Organs and conducted over 300 animal trials that were essential for developing the artificial heart. He was on the team that operated on Dr. Barney Clark. After Dr. Kolff stepped down as the head of the department, Dr. Olsen took over leadership.
Dr. George Pantalos
Dr. George Pantalos came to the University of Utah in 1983, shortly after the famous surgery. He worked in research and was instrumental in progressing the artificial heart after the Barney Clark surgery.
Dr. Barney Clark
Dr. Barney Clark was Dentist from Seattle, Washington. At the time of his surgery, he was in serious condition, dying from end-stage cardiomyopathy. He agreed to participate in experimental surgery because he wanted to progress medical innovation and improve his quality of life. Because of his brave decision, he is considered a modern pioneer.
In the months following his surgery, Dr. Clark suffered from many complications, including infection, seizures, and a broken valve on the artificial heart. Nonetheless, the medical team considered the surgery a success because of the new information they learned. Despite the difficulties that he suffered, Dr. Clark stated shortly before his death that the surgery had been worthwhile.
On November 30, 1982, University of Utah Medical Center employees received a memo. It informed them that after decades of research, the first “FDA-approved artificial heart implant in a human patient” was going to take place the following week. The memo warned employees to expect an influx of media personnel. Still, they were surprised when over 70 reporters arrived to cover the event.
Staff at the medical center navigated a madhouse of reporters for Dr. Clark’s entire four-month stay. The surgery dominated the national conversation and received significant attention from national newscasters. The fame shocked the team at the University of Utah, who did not anticipate much attention outside of the medical community- but artificial hearts had captured the public imagination.
Captured Public Attention
People were enthralled with the idea of the artificial heart. Many considered it a symbol of human progression, comparing it to landing on the moon or getting close-up photos of Saturn’s rings.
Yet, much of the public was unfamiliar with artificial organs, and some asked amusing questions. For instance, given the heart’s association with love and romance, some wondered if replacing the biological heart with a machine would change a person’s ability to love.
“I don’t think the artificial heart will influence the owner’s emotion in the least. Emotions, as far as I know, take place in the brain. It’s true we may have palpitations, a rapid heart beat when we are in love, but this is secondary. If the owner of the artificial heart would find it pleasant to have these sensations he can turn up the rate of the pump.”
-Dr. Willem Kolff
Another manifestation of public interest in the surgery was the creation of a mosaic to commemorate the event. Dr. DeVries commissioned local artist and basketball coach Ed Palubinskas to create the artwork.
When asked what inspired his art, Mr. Palubinskas recalled that he was trying to make stone come to life and “freeze the moment of greatness of humanity in time.”
Many had severe reservations about the artificial heart. Some accused Kolff, DeVries, and Jarvik of “playing God” by intervening to save seriously ill persons.
Others highlighted the ethical questions the case produced. They wondered who should be selected as a patient for future surgeries, the sickest or the least sick candidate? And, should future implants be performed more for the patient’s benefit or the benefit of experimentation and medical discovery?
The team at the University of Utah felt that the patient should be the first priority. Dr. Kolff adamantly insisted that quality of life must be taken into consideration.
“Before we apply an artificial organ to any recipient, we should ask ourselves if it will make the life of that recipient more enjoyable. And, if it does not restore him to an enjoyable life, then we should not do it. I am not the least interested in prolonging life if it’s not enjoyable. In fact, I think it’s a crime to prolong life when it means prolonging suffering.”
—Dr. Willem Kolff
Some critics claimed that research, development, and surgical implantation were too expensive. They asserted that funding might be put to better use to save healthier patients or for preventative measures that would benefit all of society rather than a few critically ill patients.
“We’ve got a duty to die and get out of the way with all of our machines and artificial hearts, so that our kids can build a reasonable life.”
-Colorado Governor Richard Lamm
Even within the medical community, many had reservations about the implications of the artificial heart. They rejected it as a “blood clot waiting to happen” and argued that physicians and researchers should instead devote time and resources to transplants.
“When you’re doing something as difficult as we are… you’re more concerned with the preservation of the species than the pecking order.” —Dr. William Pierce
Despite the pushback, others within the field of medicine supported the research and implementation of the artificial heart and sought to make it more widespread. Programs like Penn State University, the Texas Heart Institute, and the Cleveland Clinic also had artificial organ research programs. These programs would even occasionally collaborate with each other when complicated issues arose.
“It was actually a fairly small community. And you got to know people, and you felt comfortable picking up the phone to ask them a question about a certain situation that you’d encountered and see if they had any insight and vice versa. And when the opportunity permitted, we’d visit each other’s labs to see firsthand what they were doing and how they were doing it.”
-Dr. George Pantalos
Barney Clark: the One and Only
Over time, the University of Utah changed its focus from permanently implanting the artificial heart to using it as a bridge to transplant. By 1985 the medical center had established a transplant program, and directors felt it would be the best long-term solution for qualifying patients. They thought that the cost and risk of maintaining artificial hearts had more potential for long-term complications. Nevertheless, they planned to use artificial hearts for some patients, especially those who could not find a transplant or did not qualify for the transplant program.
Regardless of future attempts to utilize the artificial heart, Barney Clark’s implant was the only one performed at the University of Utah Medical Center. The transplant program successfully located hearts for patients and negated the need for artificial organs. In addition, excellent cardiologists at the hospital treated many heart failure patients with medication and avoided surgery altogether. Given these factors, the University of Utah was dropped as a clinical testing site in 1986.
A Contemporary View
Artificial hearts have come far over the last four decades. Contemporary devices are much smaller, more effective, and more cost-efficient than ever before. These devices are mainly used as a bridge to transplants rather than permanent implants. Nevertheless, patients suffering from heart disease can choose from many different models. Typically, these patients can return to the comfort of their homes while waiting for a donor heart to become available. Such medical advances would not have been possible without the foundation laid by the University of Utah.
EHSL Digital Publishing, History of the Health Sciences
Artificial Heart Collection
“Utah and the Artificial Heart: Forty Years Later” Presentation by Emma Webb, YouTube
George Pantalos Oral History, Transcript, History of the Health Sciences Digital Collection, Digital Library
Artificial Heart Historical Background, History of the Health Sciences Digital Collection, Digital Library