A retired Massachusetts high school teacher and track coach is being kept alive with an artificial heart while awaiting a transplant at Brigham and Women’s Hospital, the first use of the technology in New England to replace a patient’s failing heart.
Jim Carelli Jr., 66, who is tethered to an external power source, has not left the hospital since doctors removed his damaged heart and implanted the light-weight device Feb. 17. But he said at a news conference Thursday that he feels great and has no misgivings about the surgery, which was not announced until Thursday.
“It’s not a difficult choice when you want to live, and I wanted to live,’’ said Carelli, who lives in Holbrook and who taught at Braintree High School for 30 years.
Total artificial hearts have been widely used elsewhere as a “bridge to transplant,” but Boston surgeons have not embraced the devices, which drew worldwide headlines when they were first tested in people three decades ago.
The reluctance reflects the caution of many in the region’s medical community but also concerns about quality of life and the fact that the mechanical heart has been largely eclipsed by other technologies, such as ventricular-assist devices that can be implanted in the chest to help the human heart pump blood.
‘It’s not a difficult choice when you want to live, and I wanted to live.’
Carelli did not qualify for a ventricular-assist device, in part because his heart disease was too advanced, surgeons said. Brigham surgeons said that they implanted a total artificial heart in another patient in April, but that they are not authorized to release information about that case.
One drawback of the SynCardia Total Artificial Heart that Carelli received is that patients are typically connected to a bulky “pneumatic driver,” which resembles a large copier on wheels. Such patients must remain in the hospital until a human heart becomes available, a limitation that is hard on patients and expensive for the hospital, Dr. Gregory Couper, Carelli’s surgeon, said in an interview.
The average wait for a heart transplant is nine months. “We were reluctant to keep someone in the hospital for months,’’ said Couper, surgical director of the Heart Transplant and Circulatory Assist Program. Carelli went on the transplant waiting list in January.
The Brigham is among the hospitals testing a portable power source that patients carry over their shoulder, which allows them to go home. Carelli did not qualify for this clinical trial because his kidneys were damaged by his heart condition and he requires dialysis, although the hospital has applied to the US Food and Drug Administration for an exception. Carelli also awaits a kidney transplant.
A devoted runner, golfer, and weightlifter, Carelli said he could walk outside with the pneumatic driver, which the company nicknamed Big Blue, but he has decided not to. “That would be a tease,’’ he said. “I really don’t want to until it’s all done.’’
Artificial hearts carry risks of infection, blood clots, and stroke. Doctors said Carelli has not experienced any complications so far, but he is being monitored carefully for any sign of problems.
During the press conference, Carelli said that he began to experience heart problems three years ago after a rigorous weightlifting session. Last year, doctors diagnosed him with cardiac senile amyloidosis, a condition in which a protein accumulates in the heart muscle, causing it to thicken and weaken.
“Mr. Carelli had no other options,’’ said Dr. Mandeep Mehra, a cardiologist and executive director of the Brigham’s Center for Advanced Heart Disease. “This isn’t a procedure to be taken lightly. But had we not done it, Mr. Carelli would not be sitting here with us now.’’
Since the operation, Carelli has made tremendous progress and can exercise on a treadmill for more than an hour, doctors said.
Carelli, who sat at a table next to his wife, Jane, said the artificial heart feels no different in his chest than his heart. But, it sounds different, he said. “It’s really loud’’ and gurgles like a coffee percolator, he said.
The first total artificial heart implant was done April 4, 1969, in Houston, on a 47-year-old patient with severe heart failure. The artificial heart was replaced three days later with a human heart, but the patient died shortly after the transplant.
The forerunner of the SynCardia heart was the Jarvik 7, which was first implanted in dentist Barney Clark in Salt Lake City in 1982. He survived 112 days, but many of the early patients suffered strokes and infections.
Since then, there have been numerous advances in artificial hearts. SynCardia won FDA approval of its device in 2004, and the company says it has implanted more than 1,000.
But the idea never became as popular as the medical profession had originally hoped, said Arthur Caplan, head of medical ethics at NYU School of Medicine. Even portable devices have limitations.
“Patients are alive, but wind up tethered to an electrical power supply with batteries that don’t work for a long period,’’ he said. “It makes a lot of noise and causes side effects. It really challenges your quality of life.’’
Caplan said there also are “a lot of demands on families to make sure everything is working right and not breaking, which I don’t think people thought about or realized.’’
Abiomed Inc. of Danvers has manufactured the AbioCor Total Artificial Heart, a device with a two-chamber pump that is powered by internally rechargeable batteries. But a spokeswoman said that the company is not currently selling the device, which is believed to have caused blood clots in some patients.