Willem Kolff Interview (page: 7 / 9) Pioneer of Artificial Organs	Print Interview

Dr. DeVries, why the Jarvik-7 heart? How did it work and why was it the right design?

William DeVries: The work with the Jarvik ventricle had been going on for a long time. The air-driven heart came from NASA experiments in the early days. Dr. Kolff was smart enough to pick up on that, and pull NASA into it from the beginnings at the Cleveland Clinic. When he came to the University of Utah we had a Swan-Ganz heart made by Clifford Swan. That's the one we put in the sheep that lived 50 hours. Jarvik was a very bright engineering student who was also a medical student. He took that and modified it all in the right ways. He made several models: a Jarvik-1, Jarvik-3, Jarvik-5 and Jarvik-7. There wasn't ever a 2 a 4 or an 8, because he wanted the freedom to name it what he wanted. Many people had worked on it before that time.

At the time Barney Clark came along, that was by far the most successful heart around. That, again, was due to the good administrative capabilities of Dr. Kolff and his lab. He had young people, machinists, he had biochemists. He brought everybody together to make that Jarvik ventricle the best ventricle it could be. And at the time Barney Clark had that implanted, there was no competition. That was by far the very best heart available.

What was it made of?

William DeVries: It's made of polyurethane. That's the plastic you make roller skate wheels or skateboard wheels out of. It's a very tough plastic. It's able to move well, and is very durable in the body. The body destroys almost everything that's encapsulated in it. The body recognizes any foreign tissue. The body will try to absorb metal, and it will try to cast plastic out of the body. Polyurethane is inert. It's not entirely non-reactive, but it's very safe to put into the body. We chose polyurethane because it was strong, it was flexible, it was durable, and it was able to withstand the body's attempts to push it out.

Dr. Kolff, could you tell me why the Jarvik heart is called the Jarvik heart?

Willem Kolff: Yes. Barney Clark received the first so-called permanent artificial heart. "Permanent" has the same connotation as a permanent in a woman's hair. It's not really permanent, but it was called permanent. It worked for 112 days. Before that, nobody cared about what it was called.

For convenience's sake, when I had Dr. Kwan Gett's work on an artificial heart in my laboratory, we called that the Kwan Gett heart. When we had another doctor's work on it, we gave it his name. We have had many different hearts. But Jarvik stayed with me for seven years, and he was assigned to work on that heart, and therefore it was called the Jarvik heart.

We've had the Kwan Gett heart, the Unger heart, the Westheimer heart, the Donovan heart, the Jarvik heart. We've never had a Kolff heart. It would have been rather dull otherwise. We would have had Kolff one, two, three, four. Nobody cared until the first patient came along. Then somebody threatened to sue us and said, "It should not have been called the Jarvik heart, it should have had another name. I don't want to say who.

At that time, I suggested that the man who complained review the history of the Society of Artificial Organs. I gave his name to the society, but they wanted me to do it. So we counted the names of all the people who had worked with me on artificial hearts at the time the Jarvik heart was implanted in Barney Clark. We counted 247, and Jarvik was one of them.

Dr. DeVries, what is the status today of artificial hearts?

William DeVries: There are about four different companies that make artificial hearts. The company that makes the Jarvik artificial hearts recently went out of the business. Artificial hearts are being put in all over the world. Many of these are used as ventricular assist devices, but they're really artificial hearts. Almost every place that has a heart transplant program has artificial hearts that they use. It is estimated that 400 or 500 of these have been implanted, but it's not news anymore.

Can you tell us exactly what the operation consisted of? What were you physically doing from the beginning?

William DeVries: We took a patient into the operating room.

Get the Flash Player to see this video. Usually, we tried to do it on a Sunday morning, because it was usually quietest, and non busiest time in the hospital, didn't disrupt the other patients. We put the patient asleep, and we would open the chest, split the bone and opened the chest up. And then we put them on what's called the heart/lung machine. This is the machine that supported their circulation while we were removing the heart; then we actually removed the heart. We cut the heart out. Now the patient was kept alive on this profusion machine. And, then we would take this artificial heart, and divide it in two pieces. We'd sew one piece in, and then sew the other piece in. We'd click it together, and then start it pumping. That's how we did it. Sewed everything up, and the patient went back to his room. Most of these patients got better much faster than patients -- even patients with real hearts. And, they did real well with it.

Dr. Kolff, how would you describe to someone who doesn't really know anything about your field of work, how would you describe what's so exciting about the work to you?

Get the Flash Player to see this video. Willem Kolff: The exciting thing of course, is not so much what people say about it, but to see somebody who is doomed to die, live and be happy. I got a letter three days ago from a woman who I've never seen. And, she wrote me, "Dr. Kolff, I've been on dialysis for 18 years. You see here a picture of myself with my first grandchild. I've had a very rich life, a very full life, and thank you very much." That is the reward, that of course makes you [feel] very good. And, that also sustains you to not pay too much attention to the detractors of what you're doing.

[ Key to Success ] Passion

Do you think you were always destined to be an achiever in this field?

Willem Kolff: I don't think that's the proper way of looking at it. I wanted to make an artificial kidney that would save people. Who did it was not so important, as long as it was done. I was convinced that I could do it, and I clung to it until it was done.

Dr. DeVries, you were attracted to the hands-on aspect of surgery, literally, wouldn't you say?

William DeVries: I enjoy that.

Get the Flash Player to see this video. You start talking to patients, and the patients look at you, and they say, "You mean, you've held my heart in your hands?" And you say, "Yes, I did." You see the gleam in their eye, and the passion that they have for you at that time, and it feeds back to you. You realize, "Gee, I really did that." And it's something you would do for free.

For that feeling that you have had communication with someone's soul. It may not be the seat of the soul and the site of love, but it magnetizes me, pulls me into it. I love it for that reason.

Get the Flash Player to see this video. It pays me every time I do it. It's the most magnificent organ in the body as far as I'm concerned, and it's a very captivating thing. We have nurses and doctors come in and watch the surgery from time to time on an educational basis. It's always fun to open the chest up, expose the heart, and the first thing they do is they go, "Ooohhh!" You know, "Is that what the heart looks like?" You can be kind of proud to say, "Yes. This is what it is and these are the skills and the art that I have, and it's very rewarding."

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