Heart and Lung Institute should and could effectively spend $20 to $25 million a year for the next several years on the various phases of artificial heart development alone, and $40 to $50 million on all devices. On a cost-effectiveness basis, this artificial heart program is very attractive, and on a lives saved basis, there is a great incentive to speed up the results. We hope that the committee will recommend substantial increases in program expenditures to enable rapid completion of the artificial heart. In order to provide you with an illustration, we have taken the first engine assembly we made, and converted it into a working display which shows in principle how the device is going to function. This unit, of course, does not have the radioactive plutonium in it and so does not actually make steam and electricity. We are running it on dry cells and on compressed air which serves as an expansion gas just the way steam would, and shows the basic heart action, alternately filling and squeezing the blood-filled chambers as a natural heart would do. Thank you for the opportunity to make these comments. I have a model here to show as an illustration of what we are doing. You will see here the pulmonary side of circulation and the systematic side. We have two separate blood bags. You can see artificial heart valves working. Those are actually surgical implantation valves. The heart is running there with about half strokes now because of its connection to the partial system. Mr. FLOOD. We are old hands at this. Dr. BLAIR. I am sure you are. Mr. FLOOD. Thank you very much. Dr. BLAIR. Thank you, Mr. Chairman. (The following additional statement was submitted:) DESCRIPTION OF THE ARCO NUCLEAR COMPANY RADIOISOTOPE POWERED ARTIFICIAL HEART ENGINE BEING DEVELOPED UNDER THE MEDICAL DEVICES APPLICATIONS PROGRAM OF THE NATIONAL HEART AND LUNG INSTITUTE Introduction The technology is now available to develop a nuclear powered artificial heart which can be implanted totally in the thoracic cavity. A full-scale model of such a heart, one designed by ARCO Nuclear Company, is shown beside a model of a diseased heart in Figure 1. Note that the artificial heart is comparable in size to the human heart. Development of the device has been initiated in a program funded by the National Heart & Lung Institute. Implantation Procedure The implantation procedure for this device is described in simplified form by Dr. Magovern, Director of Surgery at Allegheny General Hospital, who has examined in detail the implantation of this artificial heart. Shown in Figure 2 is an artist's description of the human heart exposed after thoractomy, preparatory to being bypassed by the heart-lung machine. Figure 3 shows the attachment of the heart-lung machine which will serve to maintain normal patient circulation while the human heart is excised. In Figure 4 the human heart has been surgically excised and the circumferential ridges of the patient's left and right aftria can be seen as well as the severed aorta and pulmonary artery. The artificial heart will be attached to these four members. In Figure 5 the atrial cuffs of the artificial heart have been sewn to the patient's left and right atria. This is done so that the artificial heart can be simply connected or "plugged-in" to the snap-on connector of the atrial cuff, simplifying the surgical procedure and attachment of the artificial heart. Figure 6 shows the artificial heart after connection to the left and right atrial cuffs. Connections to the aorta and pulmonary artery have been surgically completed, and the heart-lung machine has been removed, leaving the patient supported by the artificial heart and his own lung oxygen absorption. Mechanical inflation of the patient's lung is still in process. The chest cavity is now closed as in any open-heart surgical procedure, and the artificial heart has taken the place of the human heart. The materials which would be used for lining the surfaces of the artificial ventricles could be one of many of the materials presently being tested by the |