About six months ago Dr. Jack Copeland cut out Chuck Besen's heart.
Besen, not surprisingly, is anxious to get a new one.
"It's kind of spooky not to have a heart," the Las Vegas bartender said in a telephone interview from the Tucson, Ariz., hospital where he awaits a heart transplant. "I hope it happens any day now. You can't have an artificial heart forever."
The 45-year-old Besen is now one of only 20 people in the world implanted with an artificial heart that is powered by a 400-pound pneumatic driver called "Big Blue."
"Chuck was in shock when he came to us," the Arizona-based Copeland said Tuesday. "He had no blood pressure. It looked like he was going to die. But that's where the total artificial heart comes in."
A modern version of the Jarvik 7 artificial heart first implanted in 1982, the CardioWest temporary Total Artificial Heart placed in Besen is now the world's only FDA- and European-approved bridge to a heart transplant.
It pumps far more blood, 9.5 liters a minute, than any other mechanical device used to replace the function of a failing heart.
A study published in the New England Journal of Medicine in 2004 said that patients on the device are successfully transplanted 79 percent of the time. The artificial heart has been placed in nearly 800 patients in North America and Europe.
Though tethered 24 hours a day by tubes to Big Blue, which looks much like a washing machine on wheels, Besen can still walk outside the renowned University Medical Center affiliated with the University of Arizona.
On an outdoor patio he often visits with his significant other, Jennifer Hokanson, and their 13-month-old son, Dylan.
At first, it was difficult to sleep with the system that belts out 140 beats per minute.
"Can you hear it?" he said, holding the phone to Big Blue.
You can. It's just a tad louder than a jazz drummer playing with brushes.
How Besen, 45, got to this time and place reveals the limitations and possibilities of modern medicine as well as the human heartache and exuberance that accompany the ups and downs of surgical interventions.
Last year, Besen had been experiencing shortness of breath, was lethargic and had a hard time sleeping. Tests showed problems with the aortic valve, which pumps blood from the heart to the rest of the body.
When Besen went into Desert Springs Hospital in Las Vegas in October, his doctors planned on doing a straight-forward aortic valve replacement, the kind of operation that comedian Robin Williams successfully underwent recently at the Cleveland Clinic.
No more than a two-week stay in the hospital and a month or two of recovery and he'd be good to go, Hokanson remembers doctors saying.
But the scheduled four-hour, open-heart operation, which has the patient on a heart-lung machine to do the work of breathing and pumping oxygenated blood for the patient, didn't go as planned, Hokanson remembers doctors telling her.
The heart didn't start to beat on its own after the valve was replaced, Besen said.
"The doctors said it was a one-in-a-million event," Hokanson said. "I freaked out. I was sure he was going to die. It was touch and go."
Besen's only chance at life was to go to a medical center that performed heart transplants.
An air ambulance loaded with life-saving equipment flew Besen to Tucson.
When Hokanson heard that the only way Besen's life could be saved was to remove his heart so an artificial one could be implanted, she was beside herself.
Within days, she suffered a collapsed lung.
"Stress does strange things to you," she said.
The 39-year-old Hokanson is a former manager of Martini's restaurant and bar at Fort Apache Road and Charleston Boulevard. Besen had the same position at the Outside Inn at Charleston and Hualapai Way. Both businesses are having benefits for the family Saturday.
Hokanson and her parents have rented an apartment in Tucson.
It is Copeland's skill, Hokanson said, that gives her hope that she won't have to raise Dylan by herself.
"I've told him (Copeland) many times that he saved not just Chuck's life, but mine, too," she said. "I can't believe how well Chuck is doing right now. That artificial heart has made Chuck strong enough for surgery. He's even working out in the gym with Big Blue beside him."
What makes Besen's case particularly dicey is that his kidneys have failed.
"It changes the physiology of his general health," said Copeland, 67.
Three times a week, Besen must undergo dialysis, an artificial process of cleansing the blood in place of normal kidney function.
If all goes well, Copeland said, Besen will have both a kidney and heart transplant on the same day with organs donated from the same deceased individual. Besen is at the top of the United Network of Organ Sharing western zone list for the double transplant.
However, Copeland said he will not swing a kidney transplant team into action unless the transplanted heart is working well.
If there is a problem with the heart that takes time to solve, he said, that could injure the donated kidney.
"We would just put him on the kidney transplant list if his heart is not stable," Copeland said.
In 1991, Copeland, Dr. Marvin J. Slepian and engineer Richard Smith founded SynCardia Systems Inc., which manufactures the CardioWest temporary Total Artificial Heart.
Smith, who has become particularly close to both Besen and Hokanson, noted Monday that two pneumatic drivers for the artificial heart that are much smaller than Big Blue are under development, with applications for FDA approval to be made soon.
One is about 40 pounds and can be wheeled around like a luggage cart; a much smaller 10-pound device could be worn in a backpack.
"I'd like to see Chuck have that kind of mobility," Smith said. "I can't imagine being stuck in the hospital like he is. But he's staying very positive. I think his child has been a particular motivation for getting through the tough times. He wants to see him grow up."
Besen, who will be the subject of a segment on the heart device on the Australian "60 Minutes," might have lost his heart, but he hasn't lost his sense of humor.
"They say that everything happens for a reason, and when you go through something like this, it builds character," he said. "Well, I'll tell you something: When I get through this, I'll be the biggest character you ever met."
Contact Review-Journal reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.