THE HUMAN HEART

THE HUMAN HEART A human heart destined for transplant lies cradled in a TransMedics Organ Care System. The device can keep a heart warm and beating—and viable for many hours longer than the conventional method for handling donor hearts: immersion in a saline solution and packing in ice. Dramatic advances in computed tomography now provide detailed scans in ten scalpel-free seconds. This image of a heart beating in a human chest reveals a narrowed artery—potential trouble. Danuel Allen lived 54 days with an artificial heart implanted in his chest. He was comforted by the thump, says Sharon, his wife, who could hear the heart beating from across the room. A couple of weeks after this photo was taken Allen received a transplanted human heart, but he died from an infection within months. More than 60,000 miles (97,000 kilometers) of arteries, veins, and capillaries in an adult body pulsate to a muscular rhythm—100,000 heartbeats a day. Scientists once viewed the cardiovascular system as a pump and a lot of pipes; now they increasingly focus Holding a photograph of their parents, six Steffensen children—JoAnn, Marvin, Jeanette, Betty, Donald, and Cecil—once confronted a disturbing question: Why have members of their family suffered from an unusually high rate of heart disease for generations? A few years ago, DNA tests revealed that stricken family members share a mutant gene called MEF2A, which produces a protein that appears to make arterial walls more likely to rupture. This polyurethane heart can keep critically ill cardiac patients alive while they await a donated human heart. Once the device is surgically implanted, its attached plastic tubes run through the patient's skin to a battery-powered pneumatic pump. Despite the cost—$106,000—the demand is strong. Some 3,000 people await heart transplants in the U.S., but only about 2,100 donor hearts are available each year. While boosting the supply of artificial hearts is a relatively simple technical hurdle, increasing the supply of human hearts is more challenging. Who will be tomorrow's donors? That question lingers for a patient in Germany, who recently received a CardioWest artificial heart like this one. At the Berlin Heart Institute in Germany, 62-year-old Siegfried Streiter endures four hours of surgery—from first incision to final sutures and bandages—to get his artificial heart. The device will not only keep him alive, says Dr. Roland Hetzer, chief surgeon; its strong, steady pulse might also help clear the chronic congestion in his lung vessels. "A transplanted human heart would have failed immediately," says Hetzer. Days after open-heart surgery, Lawrence Silberman tries to relax as massage therapist Kathleen Ullmann administers craniosacral therapy. With her gentle touch and extraordinarily sensitive fingertips, Ullmann promotes a state of deep relaxation and facilitates the flow of fluids that surround the brain and spinal cord, which can improve the functioning of the central nervous system. Meditation and yoga also help cardiac patients recover from surgery. Four months after receiving his artificial heart, Siegfried Streiter often gets out and about—but not without the rolling power pack that keeps the heart beating. The equipment beeps at him periodically, says Streiter, but he's not complaining. "The good news is, I'm alive."

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