The practice of rush-shipping organs for transplants on ice is fertile ground for slapstick comedy. It’s almost too easy—think of five things that could go wrong! Go!
So next time you have a heart that needs transporting, you might consider joining a clinical study currently underway with this little gadget: a cozy box on wheels that recreates the heart’s natural environment, complete with donated blood and tubes to pump that blood through. The study, which is funded and designed by TransMedics, the company that makes the box, is investigating whether keeping the heart going means it can be transported farther and increase the success of transplants by giving doctors more time to test for immune factors that could cause a rejection. The current system, of course, involves shutting the heart down, partaking in crazed race-against-time hijinks, and then jump-starting it once it’s in the recipient’s chest. The whole process can take no more than six hours, chest to chest, or the heart fails.
How long could a heart survive in a box? Perhaps…forever? That’s an iiiinteresting question…for another, madder group of scientists. In the meantime, if you’re anything like us, reading this has given you an urge to revisit this little number, featuring Justin Timberlake.
There are certain things you’re not supposed to do during sex and having a heart attack is one of them. We’ve known for a while that bursts of moderate to intense physical activity—including sex—increase heart attack risk, but a few scientists have now put number on that risk. And especially for out-of-shape folks, the diagnosis doesn’t look good (unless you’re aiming for death by sex, of course).
Studying death and sex is a tricky subject: Scientists can’t just round up volunteers, watch them make love, and then note which ones die. So instead they analyzed data from 14 different studies to single out connections between sex, exercise, and the risk of cardiac death or heart attacks.
As the researchers wrote in the Journal of the American Medical Association, “Acute cardiac events were significantly associated with … sexual activity.” When exercising, you’re 3.5 times more likely to get a heart attack, and when having sex (or immediately after sex), you’re 2.7 times more likely.
What to you do if a doctor says your heart’s aortic root had ballooned to nearly two inches, and that a heart attack is imminent unless you receive a mechanical valve–a fix that requires blood-thinning drugs for the rest of one’s life? Easy–just invent your own heart implant.
This was the scenario facing Tal Golesworthy in 2000. An engineer from Tewkesbury, England, Golesworthy has the same tissue disorder that afflicts over 12,000 people in the UK: Marfan syndrome. But Golesworthy decided that the valve wasn’t his only option. As The Engineer reports:
What excited him was the use of magnetic resonance imaging (MRI) and computer-aided design (CAD). He believed that by combining these technologies with rapid prototyping (RP) techniques he could manufacture a tailor-made support that would act as an internal bandage to keep his aorta in place…. “It seemed to me to be pretty obvious that you could scan the heart structure, model it with a CAD routine, then use RP to create a former on which to manufacture a device,” explained Golesworthy. “In a sense, conceptually, it was very simple to do. Actually engineering that was significantly more complex.”
The main difficulty was that the scanners had trouble imaging his beating heart, and since you can’t tell your heart to “hold still” for the camera, Golesworthy did the next best thing: he created multiple images of his heart at the same cardiac cycle. With CAD helping him design the implant, the next obstacle was how to translate a digital design to a workable heart implant. As The Engineer reports:
The team looked at a number of different processes, such as 3D embroidery, but ended up using a standard medical polymer, polyethylene terephthalate (PET) in a textile solution that allowed them to form a mesh directly onto the former. The mesh weighed less than 5g, was an exact fit for the ascending aorta and could be sutured into place by the surgeon. The process, from proposal to final product, took just under two years.
All the while, Golesworthy was working against the clock, knowing that a heart attack could rear its head at any point. From The Engineer:
“My aorta was dilating all through that period,” said Golesworthy. “When you’ve got the scalpel of Damocles hanging over your sternum, it motivates you into making things happen and so they do…”
And they did. Golesworthy created his implant and surgeons implanted it into his heart in 2004. Since then 23 other patients have had the same surgery, and the implant has the potential to become the standard for valve-surgery in the coming years–all thanks to a man who could have died from a big heart, but instead decided to share it.
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Image: flickr /Vintage Collective
Christopher Wall spent the first three years of his life in a hospital because he was born with ectopia cordis (pictured at left), a rare birth defect that made his heart form outside his chest. Considering most babies born with the condition only live for about two weeks, it’s a testament to modern medicine that Wall is alive.
The condition is incredibly rare—it only happens around eight times out of every million births. As a consequence, there is not much known about the cause of the disease except that it may be associated with Turner Syndrome [ed. note: Which, as one commenter pointed out, occurs only in females]. In some cases, the heart can end up by the neck, or on top of the chest area, or in the abdominal cavity. These days, ultrasounds and sonograms would detect the defect, and it would not be an total surprise for the expecting mother.
Life hasn’t been easy for Wall: By the time he was one and a half, he had undergone 15 surgeries. ABC reports:
“[W]e don’t know exactly why some children may carry a particular gene [for the condition] and others don’t,” said Dr. Victoria Vetter, a pediatric cardiologist at the Children’s Hospital of Philadelphia, who was on staff at the time of Christopher’s birth.
[Wall’s mother] was immediately warned that Christopher was born with a severe case of the condition and he may never survive. Her newborn son was rushed to the hospital’s neonatal intensive care unit. Without the enhanced medical procedures used today, Christopher’s condition came as a “complete surprise.”
Despite his incredible adversity, Wall’s outlook appears to remain positive—when asked about his life goals, he told ABC, “I just wanna be a good person.”
Discoblog: Child With Rare Disorder Has Backward Organs, Heart In Her Back
Image: Courtesy of Annals of Thoracic Medicine