Backpack powers heart transplant patient’s temporary replacement

A backpack power supply runs the artificial heart Chris Marshall received from UW Medical Center.

Everywhere Chris Marshall goes, he carries a small gray backpack that emits a jaunty, syncopated sound loud enough to draw the attention of people around him. It’s the cheerful beat of the 13.5-pound wearable power supply that makes his Total Artificial Heart work. It’s the sound that will accompany Marshall around-the-clock until a donor heart becomes available for transplant.

The UW Medical Center in February became the first hospital in the Pacific Northwest to discharge a patient implanted with the world’s only approved Total Artificial Heart, using the lightweight power supply dubbed the “Freedom portable driver” by SynCardia Systems, Inc. It’s a huge technological leap forward. Until recently, patients with Total Artificial Hearts had been tethered to a huge, 418-lb. machine called “Big Blue,” which confined them to the hospital while they waited for a transplant.

An artificial heart was the last thing on Marshall’s mind when he and his wife, Kathy, left their home in Wasilla, Alaska, in January, for a consult at the UW Regional Heart Center. In 1999, at the age of 38, Marshall had been diagnosed with heart failure. As the years passed, he adapted to lower and lower heart function, continuing to enjoy his work at ConocoPhillips on Alaska’s North Slope and spending time with Kathy and his two sons, now young adults.

Last fall, after symptoms of breathlessness and fluid retention worsened, his cardiologist in Alaska recommended that Marshall consider a heart transplant program. The day Marshall came to UW Medical Center, he was immediately admitted because his heart was barely working.

“They said on the ultrasound, the walls of my heart were barely moving and they’re supposed to have a pretty good squeeze,” Marshall says.

A donor heart was not available for transplant but Marshall’s UW surgeon, Dr. Nahush A. Mokadam, talked to Marshall and his wife about an artificial heart as a bridge to a heart transplant. Marshall agreed, and Mokadam, the UW’s LeRoss Endowed Professor in Cardiovascular Surgery, performed the procedure, assisted by Dr. Awori J. Hayanga, chief resident in cardiothoracic surgery. An instrument technician by trade, Chris Marshall was skeptical at first. It wasn’t the “instrument” he had expected. He had come to Seattle thinking he would get a ventricular assist device. (Not everyone is a good candidate for a VAD.) So, he didn’t agree right away to the artificial heart.

He changed his mind several days later when he suddenly developed a serious arrhythmia and lost consciousness. He realized then that his heart failure was worse than he had been willing to admit, even to himself.

“I had just gradually become used to my condition and didn’t realize how sick I really was,” he recalls.

Marshall underwent the six-hour surgery on Feb. 6 and was discharged March 21. While Marshall may need to wait up to two years to have a heart transplant, due to the scarcity of donor organs, the artificial heart is making an active life possible.

The Marshalls, who have rented an apartment in Bothell, routinely walk up to 4 miles at Marymoor Park with their golden retriever, Gracie. The driver has a battery that lasts about two hours. When the Marshalls are out and about (never more than two hours from UWMC in case a heart becomes available) and the battery runs low, Chris can recharge the driver by plugging it into the Chevy Tahoe that a co-worker loaned him for the duration of his time in Seattle.

The portable driver that Marshall has is undergoing an FDA-sanctioned clinical study to determine whether it can safely be used at home. UW Medical Center is certified by SynCardia to implant the device and the hospital is a clinical study site.

While the Marshalls miss their small hometown and their sons, they are exploring the Seattle area with gusto. Chris is not allowed to drive, so Kathy has tackled big-city traffic with the aid of a GPS unit, and they are taking day trips around the Puget Sound region.

Kathy Marshall said that the physicians and all the staff at the UW Medicine Regional Heart Center “have given Chris excellent, excellent care.” They are also thankful and amazed at the support from their hometown. Marshall’s North Slope co-workers raised more than $5,000 to offset the cost of maintaining two households while they wait for a donor heart. ConocoPhillips has told Marshall that if his current job, which requires flying to a remote North Slope site for two weeks at a time, is not OK with his cardiac team, another job will be waiting for him in Anchorage. Friends have loaned them furniture for their apartment in Bothell.

“We have everything we need here,” Kathy says. “All we need now is a heart.”

The implant is just one example of UW Medicine’s achievements in advanced heart care:

Since 1997, UW surgeons have implanted more than 280 patients with bridge-to-transplant, circulatory-support mechanisms, including ventricular assist devices. More than 90 percent of implanted patients are successfully transplanted.

UW surgeons performed the region’s fi rst heart transplant in 1985, and have performed 534 such procedures since 1988, more than any other Pacific Northwest cardiac care service.

The first adult heart-lung transplant in western Washington was performed by UW surgeons in 2007.

UW Medicine’s heart-transplant patients’ 1-, 5- and 10- year survival rates are among the best in the United States.