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From the beginning, Schroeder's treatment seemed to go more smoothly than that of his predecessor, Seattle Dentist Barney Clark, the world's first recipient of a permanent artificial heart. Clark's surgery and his 112 days of life with the man-made pump were fraught with life-and-death crises. "I felt certain that he would die on the operating table," reflected Dr. Robert Jarvik, 38, designer of the Jarvik-7 heart used in both patients. This time, he said, "I felt the opposite."
In Clark's case, surgery was complicated by the fact that the heart tissue was so damaged by years of treatment with steroids that it tore like tissue paper in DeVries' hands. To make matters worse, when the artificial heart was implanted, it failed to function properly, and a stand-by left ventricle had to be substituted. DeVries felt so frustrated, he later admitted, that "I would have picked up the artificial heart and thrown it on the floor, if the press had not been there."
In contrast, said Jarvik, Schroeder's surgery was notable for "a great feeling of deliberate, calm progress," making it seem "almost routine." The only difficulty came in removing the diseased heart, which was surrounded by a thick envelope of scar tissue, the legacy of bypass surgery performed less than two years ago. "The scarring made it difficult to identify structures," explained Lansing, who assisted in the operation. "It's like looking through a fog." As a result, instead of taking the usual five minutes, it took half an hour just to extract the organ. Once that was accomplished, DeVries easily installed the Jarvik heart, using the technique he had practiced and honed on hundreds of animals.
The first real drama of the day came about an hour after surgery when Schroeder was suddenly jolted into consciousness and, terrified by all the activity around him, tried to bolt from the bed. Doctors restrained him and increased his sedation. Five hours later they confronted a more serious problem: an alarming amount of fluid was building up in Schroeder's chest cavity and lungs and his skin was turning bluish-gray, a sign that not enough oxygenated blood was being circulated. They rushed him back to the operating room to find that he was hemorrhaging along the row of stitches connecting the artificial heart to his aorta. Doctors stanched the flow by applying pressure and clotting agents, but not before Schroeder had lost a massive amount of blood. By the next day, however, Lansing reported that the patient was back on track: his blood pressure was normal, his heartbeat steady and, he added, "where his skin was cold and gray and clammy then, it is now warm and pink and dry."
It was a stunning improvement over Schroeder's condition before surgery. According to Humana doctors, Schroeder has truly cheated death. Without the Sunday-morning implant, he "would not have survived the weekend," says DeVries. "Saturday night, I was very worried."