Health & Fitness

The Spinning Heart

(and the end of heart disease)

Greg Jones is slouched in an office chair on the ground floor of his two-story house four miles west of downtown Chicago, a Windows error frozen on the computer screen behind him. I reach for his wrist—no pulse. I feel again, shifting my fingers to cover the radial artery—still nothing. That’s when I look at his face and he gives me a big smile.

Greg Jones is not dead. Beneath the purple Vikings jersey, his chest rises and falls, steady as daylight. At 38, Jones runs a catering company that specializes in barbecue. With his laid-back attitude, it’s easy to picture him presiding over a big backyard smoker. He’s lean and large at six feet four inches and 280 pounds, if not quite as lean as he was in high school, when he played All-American Basketball.

All the same, Jones has no detectable pulse. The blood that warms his veins is being blown through him in a steady whoosh by the Thoratec HeartMate II, a continuous-flow heart pump also known as a left ventricular assist device, or LVAD. Continuous-flow pumps are the latest break­through in fully implantable LVAD technology, and they’re life­savers for guys like Jones, whose hearts aren’t strong enough to beat on their own. After years of taking their design cues from the heart itself, mimicking its pumping action with artificial valves and pneumatic diaphragms, engineers realized that what works best for flesh does not necessarily work best for plastic and metal. The upshot: a second generation of LVADs that work less like a bellows than an Evinrude. In the HeartMate II, the only moving part is a 1.5-inch rotor, spinning at 8,000 to 12,000 rpm to send reoxygenated blood back through the body.

“Sometimes, if it’s real quiet and I lie a certain way,” says Jones, “I can hear the mmmmmmmmm.”


If the 1990s were the decade of medicine, with the success of cholesterol-lowering statin drugs and the proliferation of ACE inhibitors, the 2000s are shaping up to be the decade of the device. More than 11,000 LVADs have been implanted to date in heart-attack survivors and heart-disease patients, some as young as 14, and new models are in development in labs all over the world. The latest iterations have about as much in common with early artificial hearts—such as 1982’s Jarvik 7, which was powered by a console the size of a refrigerator—as your iPod has with your grandpa’s Victrola. Today’s LVADs can weigh as little as 10 ounces and fit inside the chest cavity like a couple of cigars in your pocket.

In a way, LVADs represent just one more chapter in the ongoing partnership between flesh and tech­nology, a partnership that dates from the time the ancient Egyptians first hammered seashells into their gums to serve as dentures, to 1964, when President Lyndon Baines Johnson launched a project to develop the world’s first bionic heart. The initial expectation was that the project would cost $581,000 and take five years. These estimates were, to put it mildly, insanely optimistic. In fact, it took until 2006 for the Food and Drug Administration to approve an artificial heart, and, to date, no patient has survived for more than a year and a half.

It was back in 2001, with the success of a large-scale trial of first-generation LVADs, conducted by the National Heart, Lung, and Blood Institute, that scientists began to understand that they could achieve better results by figuring out how to work with the heart instead of trying to replace it. It was one of those simple upheavals in conventional thinking that, like the steam engine or the zipper, in a single stroke opened the doors to progress. Today, the sci-fi allure of replacing the organ long identified as the seat of human emotion with a bionic replica has in turn been replaced by a much more practical goal: Figure out what works.