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Within the next year, equipment for computerized axial tomography (known generally as a CAT scan) is expected to become available for cardiovascular use. Some of the advances in the wings: Diagnosis. Moreover, the rate of discovery has been accelerating. And heart-transplant surgery, which was all but abandoned a decade ago, has made a comeback with an unprecedented percentage of successful operations.
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Here, the breakthroughs have seemed to come in a rush - a device that can snake its way through veins and arteries to take a tissue sample from a newly implanted heart, a drug that can neutralize an enzyme that raises blood pressure, a pacemaker that can broadcast the condition of its host's heart and receive, in return, radioed instructions from outside. So most medical atten-tion is focused less on prevention than on cure. Many Americans refuse to be prudent, and many are virtually programmed for heart disease by their genes or by the effects of aging. Yet life-style changes have their limits. The effects cannot be quantified, but they are enormous. Some have been gradual - the amazing life-style changes, for example, that have left Americans smoking less, exercising more and cutting back on their cholesterol intake. The breakthroughs have come on a dozen fronts, from diet to diagnosis, from medicines to machines. The progress of the last decade, he says, ''suggests we can control and eventually eradicate heart disease.'' Levy, former head of the National Heart, Lung and Blood Institute and now at Tufts University, have learned optimism. Heart disease remains the most deadly of diseases - it killed at least 750,000 Americans last year, accounting for almost 40 percent of all deaths. The millennium is still far distant, of course. Millions more who now lead full, vigorous lives would be disabled by severe pain or other cardiac symptoms. Some 200,000 Americans now living would have died during 1982 but for the progress of the last 15 years.
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His surgery is part of an astounding medical advance, the latest in a series of giant steps toward the conquest of heart disease. Yet a significant aspect of Barney Clark's operation has been largely overlooked. Jarvik, the designer of the artificial heart -have become national figures. The two men most intimately responsible for the achievement -Dr. As of this writing, 15 weeks after the operation, the courageous patient has fought his way past one setback after another. For the first time, an alien object made of metal and plastic has permanently taken the place of a failing heart. It seemed impossible that just three months earlier he had been rushed into an operating room in the evening, so near death that the surgery could not wait until the next morning. Clark talked easily if somewhat breathlessly for the video cameras. A few weeks ago, calmly sitting there in Salt Lake City in his blue pajamas and red dressing gown, Dr. He looked out at us from millions of television screens across the nation, a latter-day Lazarus, a man whose life had been forfeit. Harry Schwartz, writer-in-residence at Columbia University's College of Physicians and Surgeons, is a former member of The New York Times's editorial board.