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The operation costs $15,000, and the equipment, including the heart, $16,450. The hospital estimates that the family will have to spend $2,700 to adapt an apartment to the patient's needs. Clark's activities will, however, be limited not only by the reach of his life lines but by the fact that the heart cannot pump enough blood to support more than moderate activity. In the past, DeVries has commented that "sex may be the most strenuous thing these patients do."
Given these limitations, what is the role of the permanent artificial heart? "The best solution remains the heart transplant," insists Dr. Christiaan Barnard, the South African surgeon who pioneered that solution. Transplants have kept patients alive for up to 14 years. (In the U.S., some 500 people have received transplants since 1967; the current five-year survival rate is 42%.)
But there are simply not enough donor hearts around for the up to 75,000 U.S. patients who need them each year. For this reason, Barnard's fellow pioneers, Michael DeBakey and Denton Cooley, say the Utah heart is an important breakthrough. Both believe, however, that it should be used only temporarily to sustain patients until donors can be found. Cooley has in fact twice used a more primitive apparatus than Jarvik's for this purpose. Says Cooley: "I've never thought of the artificial heart and transplant as being competitive. They complement each other."
Future patients may look forward to Jarvik's electrohydraulic heart, a fully portable model powered by an implantable pump and a 5-lb. battery belt worn strapped to the waist. Jarvik hopes to have the device ready in three years. He has tested it in animals. But there is already heavy demand for the model, used last week, despite all its limitations. Still, De Vries says, "I'm not prepared to do it again until we can get Dr. Clark worked out."
The dentist's progress has already exceeded everyone's expectations, including his own. Before the operation, Clark had told his son Stephen that he did not expect the surgery to succeed. By week's end, however, Dr. Peterson reported that Clark "had gone from a man who was blue from not enough oxygen before surgery to being pink." He was also talking, moving his arms and legs and, thanks to a stalwart plastic heart, beginning to enjoy a life on borrowed time.
—By Claudia Wallis. Reported by Cheryl Crooks/Salt Lake City