Editor's Note: Mr. Smith received a heart transplant on January 27, 2003 and left the Medical Center on February 18.
Ronald Smith said he felt like a "dead man walking" before receiving the Jarvik 2000 heart pump.
Ronald Smith never dreamed he would become a medical pioneer. But that's just what happened when he became the second person at the University of Maryland Medical Center to receive an experimental Jarvik 2000 heart pump, and only the second person in the United States to go home with the pump.
"I'm very shocked that I'm on this end of it, this part of medical history," said Smith as he prepared to go home. "I never thought I would be the first or second to do something like this. To have the success that I've had with the Jarvik is tremendous."
The 54-year-old Clinton, MD man left the University of Maryland Medical Center on January 8, after having the pump implanted on December 12. The Jarvik 2000, a thumb-sized, battery-powered heart pump in his left ventricle, is keeping him alive while he waits for a heart transplant.
Smith says the Jarvik has made a tremendous difference in his life.
"This Jarvik has just turned me around 200 percent," said Smith "It's a true blessing to have been afforded a second chance."
Ronald C. Smith, the second patient in the United States to go home with an experimental Jarvik 2000 heart pump to await a transplant, has achieved another milestone. Surgeons at the University of Maryland Medical Center (UMMC) successfully transplanted a new heart in Smith on January 27, 2003, and Smith went home on February 18.
"I feel wonderful, great, and energetic," Smith said. "With another heart, it's just a new life altogether."
Doctors implanted Smith's heart pump on December 12, 2002; he went home with it on January 8, 2003. He now says his transplanted heart works even better than the Jarvik 2000, which supplemented his ailing heart's pumping function and kept him alive until a transplant was possible.
"The pump [Jarvik 2000] was a bridge. It's a wonderful piece of equipment and has done wonders and miracles for me. It took me to the point where I could have a heart transplant," said Smith.
Once Smith had the transplant, he immediately noticed a difference. "With a new heart, I have more energy and I'm able to do more," he said. And he is thankful for his new chance at life.
"The heart transplant was a blessing," Smith said. "God has made this all possible. God first, and [UMMC cardiac surgeon] Dr. Griffith and his team second."
UMMC is the third hospital in the U.S. and the first on the East Coast to offer the Jarvik 2000 on an experimental basis.
The pump, removed from Smith during the transplant operation, will be analyzed and evaluated for wear as part of an FDA investigation of the device.
Smith has suffered from congestive heart failure for more than 20 years and the disease sapped the energy out of him.
"I was like a dead man walking when I came to the hospital, but I didn't realize how sick I was until I received the heart pump," said Smith. "The heart failure was draining me. I had gotten to the point where I started compensating for the lack of energy and not realizing that I couldn't do what I used to do. Mentally I was young and strong enough but physically I wasn't," he said.
Smith's heart condition made him constantly tired. "All I wanted to do was eat and sleep," he said. He avoided social events, going shopping and just doing daily tasks because he just didn't have the energy.
"Grocery shopping would drain me completely," recalled Smith. "I would come back from grocery shopping and put the perishables away and wait for someone to come home to unload the rest of the car, that's how beat I was."
And just the simple things, like going to the mall to buy his wife an anniversary present, proved to be a monumental task for Smith. He had even gotten to the point where he was using his computer to shop on-line, just to keep from having to go out.
But all of that changed when he found out about the Jarvik 2000.
It all started when Smith saw a story about the Jarvik 2000 on the television news, reporting about Woodrow Snelson, the first person to receive a Jarvik 2000 at the Medical Center. He and his wife, Ryvette, had actually been gathering information about different mechanical devices.
After watching the report, his wife did some research on the Web, (including the University of Maryland Medical Center Web site) to find out more about the Jarvik.
That was on November 11. The next day Smith had an appointment to see his cardiologist, Dr. Stephen Gottlieb, director of the Heart Failure Service and Cardiac Care Unit at the University of Maryland Medical Center, and a professor of medicine at the University of Maryland School of Medicine.
"I mentioned to him that I had seen him on television and that I was impressed with what they had to say about the Jarvik 2000," Smith said. "I talked to him about it and asked him if this would be something he considered for me down the road. He said 'we'll look at it down the road'; that's exactly what happened."
Cardiologist Stephen Gottlieb with Smith and his wife, Ryvette.
Dr. Gottlieb tried increasing Smith's medications, but that wasn't having the desired effect. Instead of upping his medications further, Dr. Gottlieb told Smith he wanted to find him a new heart. He met with Smith the day after Thanksgiving to see if he would be willing to try the Jarvik while waiting for his heart transplant. Smith immediately agreed.
"We tried medicines and usually they really help a lot of people with heart failure. But Mr. Smith wasn't doing well despite being on good medications and we felt we had to do something," Gottlieb explained. " Fortunately we had the Jarvik 2000 available, which is a relatively simple procedure compared to some of the other options."
So Smith had the Jarvik implanted on December 12, ten days after being admitted into the Medical Center. Gottlieb was quite pleased with the results.
"He has done spectacularly," said Gottlieb. "He has recovered well. He can exercise, his organs are functioning well and it's made it possible to give him time to be home, to be active and to get stronger so that even when it does come time for the cardiac transplant his chances will be much better."
The Jarvik 2000 heart pump. Smith is the second Medical Center patient, and second person in the U.S., to go home with this device.
The Jarvik 2000 heart pump produces continuous blood flow, but not a pulse. It was designed by Dr. Robert Jarvik, inventor of the Jarvik 7 artificial heart, to reduce the risk of clotting and infection associated with older heart pumps. Unlike other types of pumps, the Jarvik 2000's small size could help thinner adults and children with heart failure.
Mrs. Smith, herself a former cardiac nurse, marveled at the improvements in ventricular assist devices such as the development of the Jarvik 2000.
"Many years ago when I did open heart surgery nursing, we had a ventricular assist device that was a huge bulky thing. It was almost as tall and twice as wide as I am," recalled Mrs. Smith. "To realize that in almost 25 years, the device has come down to the size of a C battery, it's just phenomenal, absolutely phenomenal."
Mrs. Smith now works at Prince Georges Hospital Center as a nursing administrative coordinator.
Gottlieb says that hopefully, the Jarvik 2000 can improve the time that people are waiting for transplants, make people stronger, and make them able to live until the time when they can get a transplant.
"Mr. Smith has been our star patient - he has really worked hard, built himself up. I wish all patients were like him," Gottlieb said.
Smith and his wife, Ryvette, share a smile before leaving the Medical Center.
Since the operation, Smith has noticed a dramatic improvement in his condition.
"My energy levels are up now, and I'm ready to go out there and have fun again," Smith said. "And I know now that since I've had the Jarvik put in me, that life's not going to be the same. I'm excited. I'm actually looking forward to going shopping, going out to dinner, and just doing the day-to-day stuff people do. I'm ready to run with the big boys again," said Smith, with a smile.
He has even given advice to another Medical Center patient who is going to receive a Jarvik 2000. "I told him that it's worthwhile to get this done even though you're going to be one of a select group to do something like this, because it changes your life completely."
Mrs. Smith is grateful to have her husband home again, and praised his cardiac team at the Medical Center.
"If I had a million dollars they would each have a million and they wouldn't have to share it. It's a million-dollar team, and a million-dollar institution," said Mrs. Smith. "We have had the finest care. His doctors, nurses, and the rest of the staff have all been wonderful."