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Jarvik, Robert Koffler

Robert Koffler Jarvik

Physician and inventor Robert K. Jarvik (born 1946) helped design and build the first artificial heart used in a human being. He is also the founder of Jarvik Research, Inc., where he began work on the Jarvik 2000 Left–Ventricular Assist System. He holds numerous patents for medical device technology.

Robert Koffler Jarvik was born on May 11, 1946, in Midland, Michigan, to Norman Eugene, a surgeon, and Edythe (Koffler) Jarvik. He was raised in Stamford, Connecticut.

As a youngster, Jarvik's early interests included mechanics and medicine, and both would greatly influence his life's work. A tinkerer, he enjoyed taking things apart and then reassembling them to better understand how they worked. In his teens, Jarvik would watch his father perform surgeries in an operating room. This exposure sparked an interest in the design of surgical tools, and Jarvik obtained his first patent before he even graduated from high school, for an automatic stapler that freed physicians from having to manually clamp and tie blood vessels during surgeries.

Father's Illness Led to Medical Education

Along with his mechanical inclinations, Jarvik also had an avid interest in the arts, especially sculpture. He managed to combine these divergent pursuits in his course load when he entered Syracuse University in 1964, where he studied mechanical drawing and architecture. At one point, he even considered a career in art.

After his father developed heart disease, however, he felt compelled to change his educational and career direction. His father developed an aneurysm and was operated on by heart surgeon Michael DeBakey. DeBakey became well known as the creator of the mobile army surgical hospitals, or MASH units. By Dr. DeBakey's example, Jarvik was encouraged to change his major to pre–medicine, and he signed up for the appropriate course work. His father's heart disease would also later lead him in the direction of artificial heart research.

Turned Down by Medical Schools

But, in the meantime, Jarvik was having some trouble realizing his immediate dreams. After he graduated in 1968 with a bachelor's degree in zoology, his medical plans were thwarted by his grades, which were inadequate for acceptance in an American medical school. By Jarvik's own admission, he was rejected by about 25 different medical schools in the United States.

Disappointed but undaunted, Jarvik enrolled in medical school at the University of Bologna in Italy. He returned to the United States after two years, however, choosing a direction of study that combined his medical ambitions with his mechanical interests: He enrolled in New York University and worked toward a degree in occupational biomechanics. He received his M.A. from the university in 1971.

Entered Artificial Heart Research Program

After graduation, Jarvik worked at a surgical supply house, but he still harbored hopes of becoming a doctor, so he applied for a job with the artificial organs program at a division of the University of Utah in Salt Lake City. He hoped the experience would help gain him entrance into an American medical school.

Jarvik worked as an assistant design engineer to Willem Kolff, the director of the university's Institute for Biomedical Engineering and Division of Artificial Organs. Kolff was considered the leading authority in the field and helped pioneer research on artificial hearts. During World War II, he developed the first kidney dialysis machine. In the mid–1950s, he began work on developing an artificial heart, which became the primary goal of his division at Utah in 1967.

Jarvik's immediate plans worked out. Through his work with Kolff, he was accepted into Utah's medical school. He finally earned his degree in 1976. The good fortune, however, was tempered by personal tragedy. That same year, his father died of an aneurysm.

Jarvik's involvement with Kolff not only led to a medical degree, but would result in Jarvik's own ground–breaking achievements in biomedical engineering, specifically in the area of artificial hearts. Jarvik's inventiveness would help researchers surmount several challenges associated with artificial heart devices.

By the time Jarvik came to Utah, artificial heart designs had already been developed. Famed ventriloquist Paul Winchell, who was also a medical doctor and inventor, had patented an artificial heart in the 1950s. By 1957, Kolff had tested artificial heart models in animals. In 1969, a team of researchers at the Texas Heart Institute, led by Denton Cooley, used a model to keep a human patient alive for more than 60 hours. Up to this point, all efforts were hopeful, but some problems remained.

At Utah, the main problem facing researchers was creating a pump with an adequate power source. They sought to design a single unit that would contain both the heart pump (which would be a re–creation of the two lower ventricles of the heart, which are the organ's pumping portion) and a power source. This unit would be positioned completely within a patient's body. Kolf tried a nuclear power source and then tried a solution involving a power from compressed air produced from a machine located outside the body and connected by tubes to the artificial heart. The latter solution was workable, but it had a major drawback: the patient would have to be permanently attached by tubes to the machine.

Developed the Jarvik – 3 and Jarvik – 7

By the time Jarvik came to the institute, the research team had developed the "Kwann–Gett heart," named after team member Clifford S. Kwann–Gett. Within the device, a rubber diaphragm acted as the pumping element, moving blood in and out of the artificial heart. This innovation decreased the chance of mechanical failure. In tests, animals fitted with the heart lived up to two weeks. Still, the rubber diaphragm caused excessive clotting, which could lead to death.

Jarvik developed an improved version of the heart, called the "Jarvik–3." The clotting problem was resolved by replacing the rubber of the diaphragm with three flexible layers of smooth polyurethane called biomer.

After further experimentation, Jarvik developed the Jarvik–7. The device was made of dacron polyester, plastic, and aluminum, and it had an internal power system that regulated the pump through a system of compressed air hoses that entered the heart through the chest. In animal tests, Jarvik and his team made sure this "heart" could beat at least 100,000 times a day with consistency. Then they felt it was ready to be tested in a human subject.

After Food and Drug Administration (FDA) approval was obtained, the "Jarvik–7" was implanted into retired dentist and heart patient Barney Clark on December 2, 1982. Jarvik's team had envisioned the implant as a permanent replacement organ. The main benefits of using an artificial heart instead of transplanting a natural one were that there would be no wait for a human heart to become available for transplantation, and there would be no chance of rejection of a foreign tissue.

The Clark Implant

The 61–year–old Clark suffered from advanced cardiomyopathy, a degenerative disease of the heart muscles. As this was a terminal illness, Clark would inevitably die from his disease. As such, he firmly believed that only an experimental form of treatment, such as a "Jarvik–7 implant," could offer any hope of saving his life. He also felt that his participation in the first implant would help advance medical science.

The implant operation was performed by Dr. William C. DeVries, with assistance from Jarvik, and a surgical team at the University of Utah Medical Center. It took seven–and–a–half hours to complete, and news of the operation was reported around the world.

Clark only lived for 112 days after the operation, but when he died of multiple organ failure, the Jarvik–7 was still working. Subsequently, several other terminally ill patients underwent Jarvik–7 implants, but the longest survivor lived only 620 days.

Implants Generated Controversy

Some rather harsh criticisms were directed at artificial heart implantations. Some of the main issues of contention involved costs and medical ethics. Some argued that the cost of the operation and implantation (between $100,000 and $200,000) was too high. Proponents countered that transplants and other procedures were expensive, too.

In the area of ethics, some said that the operations were essentially experiments that turned patients into human guinea pigs, because natural transplants remained effective and even superior. Others said it significantly reduced a patient's quality of life. Jarvik himself countered that he'd never perform the operation on anyone if he didn't believe it would make the quality of their life better than what it was.

Eventually, the Jarvik–7 was eventually used only as a temporary measure for patients awaiting natural hearts transplantations. Still, it marked a great leap forward in biomechanics. "My invention was important to history because it was the first permanent heart and it helped cardiac patients live longer while waiting for donor hearts," recalled Jarvik. "It was a medical breakthrough. It probably wouldn't have been a breakthrough if it wasn't for the courage of Barney Clark."

By the end of the 1980s, about 70 devices had been implanted in patients who were waiting for transplants.

Entered Business

The year before the Clark operation, in 1981, Jarvik was named president of Symbion, Inc., an artificial organs research firm founded Kolff. Originally, the company focused on the heart, but Jarvik helped lead it into the development of manufacture of other organs, such as an artificial ear.

Jarvik stayed with Symbion, and remained at the University of Utah, until 1987 when he moved to New York City and formed his own company, Jarvik Research, Inc. After Jarvik left, federal funding for the Jarvik project came to an end and, in 1988, and artificial heart implantation was used for temporary implantation only. In Manhattan, Jarvik continued conducting artificial heart research and focused his efforts on a new model.

The Jarvik 2000

By 1998, Jarvik was developing a new model called the Jarvik 2000, a left–ventricular assist system. The most significant difference from earlier models was that natural heart did not have to be removed. Rather, a small device could be inserted into the left ventricle to provide pumping action (i.e., both the pump and power source would be implanted inside the heart). The advantages of this design, as Jarvik saw it, was that if you boost the output of the natural heart and keep it working, the heart still regulates the body's needs and the amount of blood flow. In addition, by placing the device directly inside the heart, it lowers the risk of infection.

In September 2002, the University of Maryland Medical Center became the third center in the United States to implant the Jarvik 2000 into a patient's heart. Jarvik assisted Medical Center Chief of Cardiac Surgery Bartley Griffith M.D., during the procedure. In an interview conducted after the procedure, Jarvik described the device on the University of Maryland Website: "It's a miniature rotary pump, it's electrically powered and is approximately a pacemaker–sized booster pump for the heart. We call it a flowmaker. The Jarvik 2000 boosts the work that the left side of the heart can do. It goes inside the left ventricle, and that's very important because that indicates it's very tiny. It's also silent and it moves with the natural heart as the heart beats. So it doesn't interfere with the motion of the natural heart, and that helps the natural heart recover."

The goal of the device, he explained, is to rehabilitate patients suffering severe congestive heart failure so that they can enjoy more mobility and a more normal lifestyle. Ultimately, the device will not be used as a bridge to a transplant device but will actually be a lifetime device.

Recognized

Jarvik has also performed research on other artificial organs and authored more than 60 technical articles. He holds a number of patents on medical devices. In addition, he has received numerous awards for his achievements throughout his career. In 1982, the Intellectual Property Owners, a trade association of inventors, named him inventor of the year. That same year, he received a Brotherhood Citation from the Utah chapter of the National Conference of Christians and Jews, the American Academy of Achievement's Golden Plate award, the John W. Hyatt award from the Society of Plastics Engineers, and the Utah Heart Association's Gold Heart award. Jarvik also holds honorary doctorates from Syracuse University and Hahnemann University, presented in 1983 and 1985 respectively.

Married the "Smartest Person in the World"

In August 1987, Jarvik married writer Marilyn vos Savant who, according to the Guinness Book of World's Records, holds the world's highest intelligence quotient (I.Q.). With a score of 228, she is 88 points smarter than the next smartest genius. Vos Savant is an author and pens a highly read column on intelligence in the Sunday weekly Parade magazine.

Previously, Jarvik was married on October 5, 1968, to journalist Elaine Levin. They were divorced in 1985. The marriage produced two children, Tyler and Kate.

Outside of biomedical and biomechanical interests, Jarvik enjoys reading, poetry, weight–lifting, and downhill and cross–country skiing.

Books

Contemporary Newsmakers, Gale Research, 1986.

World of Health Gale Group, 2000.

Online

"About Us," Jarvik Heart, http://www.jarvikheart.com/basic.asp?id=43 (December 30, 2004).

"Electric Heart," NOVA, http://www.pbs.org/wgbh/nova/transcripts/2617eheart.html (December 30, 2004).

Lindsley, Chris, "Dr. Jarvik on the Jarvik 2000: A Q&A with the Famous Inventor and Cardiac Pioneer," University of Maryland Medical System, http://www.umm.edu/heart/jarvikQA .html (December 30, 2004).

"Robert Jarvik–Artificial Heart," Inventor of the Week, http://inventors.about.com/gi/dynamic/offsite.htm?site=http://web.mit.edu/invent/iow/jarvik.html (December 30, 2004).

"Robert Jarvik Returns," Red Herring Magazine, http://www.deaftoday.com/news/archives/000015.html (December 30, 2004).

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