The U.S. Food and Drug Administration (FDA) has approved the first completely implantable artificial heart, the AbioCor Implantable Replacement Heart, offering a new option for patients with severe heart failure who are not eligible for a heart transplant. This groundbreaking device provides a lifeline for individuals facing imminent death due to heart failure.
Device Approval and Intended Use
The FDA's approval, granted under the Humanitarian Use Device provisions, restricts the use of the AbioCor to a limited number of patients annually (under 4,000 units). The device is specifically intended for individuals with acute heart failure who cannot undergo heart transplantation and are predicted to live no more than one month. Dr. Daniel Schultz, director of the FDA's Center for Devices and Radiological Health, emphasized that this technology offers a crucial alternative for end-stage patients facing immediate mortality.
Clinical Trial Outcomes
Clinical trials involving 14 men demonstrated that the AbioCor extended survival by an average of 4.5 months. Some patients experienced significantly longer survival, with two individuals living for 10 and 17 months, respectively. Dr. Bram Zuckerman, director of the FDA's Division of Cardiovascular Devices, noted that the device allowed patients to spend valuable time with their loved ones. One patient was even discharged from the hospital.
Device Components and Function
The AbioCor is a 2-pound mechanical heart that replaces the patient's own heart. The system includes a power transfer coil that charges the device through the skin, an internal battery, and a controller implanted in the patient's abdomen. The controller monitors and regulates the device's pumping rate. The internal battery allows patients to be free from external connections for up to an hour. Two external batteries are also included, providing approximately 2 hours of mobility. The system can also be charged by plugging into an electrical outlet.
Patient Suitability and Post-Market Review
Due to its size, the AbioCor is currently suitable only for individuals who are at least 6 feet tall and weigh at least 170 pounds, potentially limiting its use in many women. Following the FDA approval, Abiomed Inc. will conduct a post-market review at 10 U.S. locations to assess the device's use and safety, paving the way for future improvements.
Expert Commentary
While the AbioCor represents a significant advancement, experts emphasize that it will not replace heart transplantation from human donors. Dr. Byron K. Lee, an assistant professor of cardiology at the University of California, San Francisco, noted that traditional heart transplants offer numerous advantages. However, the artificial heart provides an improved quality of life for patients who do not qualify for traditional transplants.
Cost and Future Development
The AbioCor device is estimated to cost around $250,000. The extent of insurance coverage remains uncertain. The FDA and medical community hope that the approval of the AbioCor will encourage further refinement and improvement of artificial heart technology, ultimately leading to more accessible and effective solutions for patients with severe heart failure.
