Today, however, research would have us believe that the ability to love and bond with others stems not from our hearts but from our brains. The heart is, scientists say, a mere cog that pumps blood. The brain is the thinking part that controls love and bonding. Sad? It is. Yet we may never know if the poor human heart takes these taunts to heart; but what is heartening is that, unmindful of myriad heartless people, the human heart goes on beating and, as the pop song says, keeps on repeating… Or else we would die!
Small wonder that doctors devote so much attention to this minuscule organ. The last two decades have witnessed many a breakthrough in the fight against heart disease. But, despite, there are times when the heart caves in and heart illness progresses inexorably to the perilous end-stage where humans have only a few days (or months) to live.
There’s new hope, though, in the horizon. Medical science is doing its best to add years to life and life to years. Here are some possible solutions:-
First is the attempt to create a total artificial heart (TAH), a traption to replace both ventricles of the living heart. The entire biological heart is removed, and the man-made tiny device of titanium or plastic is positioned in its place. Powered by batteries, most TAHs mimic the natural heart’s rhythm, drawing and pumping blood in pulses. But they require a great deal of complexity and precision difficult to achieve. Therefore, TAHs have not found wide acceptance except as a “bridge” to heart transplant.
Second is heart transplantation from cadavers. For a successful transplant, the donor and the recipient team must work in close coordination. A heart harvested at one place must reach the recipient’s hospital within less than 30 minutes. It is stored in cold ice and rushed through a “green corridor” to the site where the recipient is waiting for a new heart… and a new life! The recipient’s damaged heart is discarded and the donor’s beating heart is carefully sutured by surgeons to the exposed vessels of the recipient’s heart. The surgery being delicate and complex is performed only by those sufficiently skilled in this type of operation. Survival rate is about 85% at 1 year. Complications like rejection and infection limit survival. Following transplantation, patients must take lifelong drugs to prevent rejection, which in turn may render them susceptible to infections and cancers. However, the greatest obstacle in today’s world is that there are far more patients on waitlists for a transplant than there are donor’s hearts.
Third is the attempt to create hearts in a lab from stem cells. Dr. Doris Taylor is in the vanguard of researchers looking to engineer entire new organs. The strategy is simple enough in principle. First, all the cells from a dead organ are removed — they don’t even have to be from a human — then taking the protein scaffold left behind it is repopulated with stem cells immunologically matched to the patient in need. Voilà!
Recently, Mount Sinai researchers in New York have gone a step further. They succeeded in engineering cardiac tissue from human embryonic stem cells to the extent that the resulting muscle has remarkable similarities to native heart muscle, including the ability to beat and contract like the human heart. The final challenge is one of the hardest: placing a newly grown, engineered heart into a human and keeping it beating for a long time. To be sure, our hearts are more than just a pile of cells and therein lies the rub.
In the wake of these astounding experiments, some are already saying it will only be a few years before not only manmade hearts are created but even manmade life is unveiled in the laboratory. But others have a less “bright” view and see what is happening as potentially dangerous. They suggest that this type of technology could turn out to be the scary side of “playing God”.
My own take is that tissues as complex as those of the heart will be created in the lab which will turn out to be a big boon for the treatment of hearts badly scarred by disease. But, to be precise, we are an eternity away from creating human life out of nothing in the lab. After all, that is God’s preserve!
(Dr. Francisco Colaço is a Senior
consulting physician and pioneer of Echocardiography)
