Artifical Heart

Artifical Heart - PERSPECTIVE curred by consuming beef, but...

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n engl j med 350;6 www.nejm.org february 5, 2004 542 PERSPECTIVE curred by consuming beef, but they should press authorities to test more cattle, to strengthen the regulations on feed production, and to extend the ban on brain and spinal cord in food for human consumption to include cattle younger than 30 months of age. From the Department of Infectious Disease Epidemiology, Imperi- al College, London. 1. BSE: homepage. London: Department for Environment, Food and Rural Affairs (DEFRA), 2003. (Accessed January 16, 2004, at http://www.defra.gov.uk/animalh/bse/index.html.) 2. Anderson RM, Donnelly CA, Ferguson NM, et al. Transmis- sion dynamics and epidemiology of BSE in British cattle. Nature 1996;382:779-88. [Erratum, Nature 1997;384:302.] 3. Ferguson NM, Donnelly CA. Assessment of risk posed by bovine spongiform encephalopathy in Cattle in Great Britain and the impact of potential changes to current control measures. Proc R Soc Lond B Biol Sci 2003;270:1579-84. 4. Monthly Creutzfeldt-Jakob disease statistics. London: Depart- ment of Health, 2004. (Accessed January 16, 2004, at http://www. doh.gov.uk/cjd/index.htm) At 10:30 p.m. on December 1, 1982, a retired dentist named Barney Clark was wheeled into an operating room at the University of Utah Medical Center in Salt Lake City. Clark, who was 61 years old, had end- stage congestive heart failure. When his condition acutely worsened that night in the middle of a heavy snowstorm, his doctors decided to press ahead with the world’s first implantation of a permanent artifi- cial heart. By the time the seven-hour operation was over, it had unleashed a blizzard of a different kind. By all accounts, when Clark was hospitalized in late November, he was at the end of his life. For months, he had had virtually intolerable shortness of breath, nausea, and fatigue. On Thanksgiving Day, family members had to carry him to the dinner table at his home in Seattle, but he was unable to eat. In the intensive care unit in Salt Lake City, he was placed in a dark room, and visitation was restricted because doctors feared that any sort of excitement could precipitate a life-threatening arrhythmia. In the words of William DeVries, the lead surgeon, and his colleagues, whose landmark report appeared 20 years ago this week in the Journal, 1 “death appeared imminent within hours to days.” Because of his age and severe emphysema, Clark was not eligible for a heart transplant. When his
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Artifical Heart - PERSPECTIVE curred by consuming beef, but...

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