GO IN DEPTH

Heart 1: Transplant

What You Need

 
Heart 1: Transplant "Heart anterior exterior view" by Patrick J. Lynch, medical illustrator. Licensed under Creative Commons Attribution 2.5 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Heart_anterior_exterior_view.jp

Purpose

To understand the workings and anatomy of the heart and to learn about new medical techniques that help people live longer, healthier lives.


Context

This lesson is the first of a two-part series that explores different aspects of the human heart and the various changing conditions that have affected the health of billions of people from prehistoric to modern times.

This first lesson, Heart 1: Transplant, focuses on the state of medical care of the human heart today and on modern medical advances—such as heart transplants—that "give today's human beings a better chance of staying healthy than their forebears had," as noted in the first part of the benchmark for this lesson. The second lesson, Heart 2: Changing Lifestyles and Health, examines the history of human diet and trends in care of the heart, comparing it with today's eating habits and lifestyles, many of which "may not be good for human health."

Few students walk around in the hustle and bustle of modern life being fully aware of themselves as human organisms that are made up of a plethora of body parts and systems that require certain types and amounts of food and exercise to optimize and prolong their performance and life. However, by the end of elementary school, students should know that good health involves a healthy diet, regular exercise, and the avoidance or limitation of certain substances that negatively impact healthy body operation—like tobacco, alcohol, drugs, and pollution.

By high school, students should also be aware that physical health continues to be threatened by outside organisms like bacteria, fungi, viruses, and infectious disease, many of which are rejected by the body's own natural defenses, like the skin, various body secretions, and the immune system. However, certain types of viral diseases—like AIDS—can break down these natural barriers and leave a person rattled with life-threatening infections. In addition to infectious disease, students should also have an understanding that their health can be threatened by internal malfunctions in their body parts or systems. These may be caused by "deviant genes," which are either inherited or formed through mutation and which can leave the body more susceptible to developing certain diseases, like heart disease or depression. Changing physical environments, social settings, and living habits—as compared to habits during prehistoric times—can also negatively impact a person's physical health, though medical science continues to develop new techniques to identify, diagnose, treat, prevent, and monitor disease. (Science for All Americans, pp. 80–82, 143–146.) These and other related factors will be explored and emphasized in this two-part lesson series on the heart.

Research has shown a number of misconceptions students have about physical health that are worth addressing and alleviating in the course of these lessons. For example, studies indicate that a sizeable proportion of adults have little knowledge of internal organs or their location. Regarding the heart, researchers have discovered that upper elementary school students realize that the heart is a pump, but they are not aware that the blood returns to the heart. Also, researchers found that students of all ages hold wrong ideas about the structure and function of blood, the structure and function of the heart, the circulatory pattern, the circulatory/respiratory relationships, and the closed system of circulation (and that these misconceptions are difficult to change). And, while many students associate health primarily with food and fitness, it has been shown that middle-school and high-school students' wrong ideas about the causes of health and illness may derive from cultural knowledge. Further, students tend to believe that they have very little personal control over their health and life spans. They also are often unable to explain their knowledge about nutrition and fitness in scientific terms. (Benchmarks for Science Literacy, pp. 344–346.)

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Planning Ahead

The student esheet will guide students to all of the web resources used in this lesson.


Motivation

Before students begin their online journey into the the heart, pique their interest by asking warm-up questions like those suggested below.

Note: Allow 5 to 7 minutes for this activity. Encourage short, fast answers. Accept all responses and do not provide explanations. The purpose of this exercise is simply to draw out what students know about and how they perceive the heart. After this discussion, convey to students that these and other questions will probably be addressed by the end of this lesson series.

Ask students:

  • What can you tell me about the human heart?
  • What does it do? What is its purpose?
  • Where is it located in the body?
  • What different parts make up the heart?
  • What foods or lifestyles are bad for the heart? Good for the heart?
  • What do you know about heart disease?
  • What kinds of modern medical advances have helped to make hearts healthier?

(Accept all answers and opinions.)

Next, direct students' attention to PBS's Affairs of the Heart online Heart Stats game and quiz activity, which is found under Web Features in the grey, center box on the page. (Shockwave is necessary for this activity.) Have students work through this short, fun, and interesting activity to provide them with answers on the heart's actual anatomy and some of the basic workings and vital statistics of the heart.

The game is like an anatomy puzzle asking for students to put together the different parts of the heart, while answering interesting factual and statistical questions about the heart as they progress. As they play through, have students jot down some of the things that surprised them about the heart. Use these points as a basis for discussion (before leading them into the main part of the lesson).


Development

Affairs of the Heart
Once students are well oriented and motivated, have them read Searching for a Substitute, the feature article from PBS's Affairs of the Heart.

This article recounts the history and evolution of the American medical and science establishment's attempts to address and resolve the great chasm between those dying of heart disease each year (45,000) and donor hearts that are available to them (3,000). Since 1964, each attempt to provide a substitute heart to meet the demand—whether with an artificial heart or an animal heart transplant—has resulted in considerable difficulties and controversies. These continue to accompany any improvements that are made.

For this reason, it is recommended that you conduct a two-part discussion of the material. First, after students finish reading and taking notes, ask them simple review and comprehension questions on the key points and events of the article. Second, expand the discussion into an "Open Forum" activity so students can better ingest, relate to, and debate the highly controversial aspects of heart transplantation since its origins.

Use the following questions to guide your first-part, fact-based review of the material after students finish reading. Use the Class Discussion teacher sheet for this activity.

Ask students:

  • Why is there an interest in substitute heart transplants?
  • When was the first attempt at finding a substitute heart? What happened?
  • Twenty years later, how was Barney Clark's experience any different?
  • Why do you think the government and public remained averse to artificial hearts after Clark's death?
  • What is the life expectancy of donated human heart transplant patients today?
  • What are LVADs? Why are they important? Remarkable?
  • What kinds of roles is modern science playing in the realm of substitute heart transplantation?
  • What sorts of complications or issues have surfaced from the use of primate and pig organ transplants?

Open Forum Discussion
Quickly divide the class into three groups: (1) those representing the doctors and scientists involved in transplantation, (2) those patients who are waiting for donor hearts and dying of heart disease, and (3) the general public. Begin by addressing each student at random with debatable discussion questions like the ones below. Encourage each group to respond to each other's views, claims, and assertions, since the purpose of this activity is to spark debate and get students into the thick of this ongoing public concern with great moral and ethical dilemmas.

Ask members of the medical and science community:

  • In considering animal heart transplants, is the life of one person worth risking the lives of thousands of others through the risk of disease?
  • Do you think it is right to design and alter animal genes for human purposes or to play God?
  • What kinds of measures or programs can be proposed to help prevent heart disease in the first place?

Ask members representing waiting heart disease patients:

  • How do you feel about substitute heart transplantation?
  • If you had to choose, which would you prefer, an artificial or animal heart transplant? Why?
  • What do you think the government and medical and science establishment should do now to improve this situation in the future?

Ask members of the public:

  • Do you support the pursuit and development of substitute heart transplants? Why or why not?
  • Which field of development do you think should be pursued, artificial or animal transplantation? Why?
  • Consider the dangers of animal transplants. What other avenues should be considered to meet the need for heart transplants?

(Accept all responses and encourage students to support their feelings and views.)

Teachers Note: If you are dividing this lesson into two classes, this would be a good place to end the first part of the lesson.


Electric Heart
If appropriate, briefly review what students learned and discussed in the first part of this lesson. Then, have them read through and participate in the following areas of NOVA Online’s Electric Heart site.

Amazing Heart Facts
After reading this list, have students activate the "See the valves in action" link at the end of the page, which will lead them to the animated Map of the Human Heart, highlighting the anatomy and how blood flows through the heart.

Ask these and other questions about the reading. Note: Depending on your teaching goals and the level of your students, you may ask harder and more specific technical questions about the anatomy and operations of the heart than the ones suggested below. Answers to the questions can be found on your Class Discussion teacher sheet.

  • What kinds of things did you learn from the Amazing Heart Facts reading?
  • Which facts did you find most interesting or enlightening? Why?
  • What is the first step in how the heart moves blood? Second? Third? Etc.
  • What are the benefits of knowing these facts about the heart and how it works?

Treating a Sick Heart
This book excerpt explores the nature and causes of heart disease and current medical techniques to alleviate them (which is consistent with the benchmark focus of this lesson). Encourage students to take notes as they read about how sick hearts are treated today. After they finish, use the general review questions below as a guide in gauging student comprehension. As usual, adjust your questions to meet your broader teaching goals and the levels of your students. For answers to the questions, see the Class Discussion teacher sheet.

Ask students:

  • What is the primary function of the heart?
  • What determines the rate at which the heart beats?
  • What is meant by "heart failure"?
  • What are the causes of heart disease?
  • In what ways is heart disease treated?

Operation Heart Transplant
Have students first read the introduction of this activity, making sure they realize that: (1) hundreds of people die each year waiting for donor hearts and (2) a few thousand highly intricate transplant operations are done each year, often lasting over seven hours.

Next, have students perform an animated heart transplant operation on a 42-year-old male patient in NOVA Online's Operation: Heart Transplant. This exciting and insightful 19-step operation will give them a more realistic idea of what is involved in heart transplant operations (and how far medicine, science, and technology have come to prolong life and aid humanity).

When students are finished, elicit their feelings and reactions about the operation by asking questions like the ones below. General comprehension questions can range from the kinds of tools, procedures, and mindset needed to perform such a delicate, challenging, and often stomach-turning procedure.

Ask students:

  • How did your operations go? What did you think?
  • What was your impression of the level of medicine, science, and technology involved in the operation?
  • If you could, would you observe or take part in such an operation in real life? Why or why not?
  • Which of the steps or instruments did you find most interesting? Challenging? Troubling? Why?
  • What would be your reaction if your patient died?
  • How did performing this operation affect how you feel about heart transplantation or the use of artificial, animal substitutes for human hearts?

(Accept all responses and encourage students to support their feelings and views.)


Assessment

Using the student esheet as a guide, have students write a short essay on the following topic: Briefly describe the function of the heart, how it can be impaired, and what solutions we have for this. Discuss the instances in which a transplant would be a suitable solution for heart disease.

Student responses should reflect an understanding of the heart as the organ that pumps blood to all parts of the body, bringing nutrients and oxygen to the tissues and removing waste products. Students should describe as causes of heart disease such things as coronary heart disease, drug and alcohol abuse, heart valve abnormalities, and heart muscle disease. They should also recognize that prevention, including a good diet, regular exercise, regular medical checkups, limiting alcohol use, and avoiding the use of tobacco or illegal substances is the best way to guard against heart disease. In addition, there are drugs and other therapies and/or surgeries available to help alleviate heart disease, but a transplant is an option only to remedy the most serious of heart conditions.


Extensions

Follow this lesson with the second lesson in the Heart series: Heart 2: Changing Lifestyles and Health.


The Artificial Human
Direct students to this fascinating resource that highlights current developments in the area of artificial organs, skin, and body parts. By clicking on the different parts of this artificial "$6 Million Dollar Man," they'll learn just some of the ways in which artificial devices have enhanced and prolonged human life.

The information and developments presented on this site reflect advances only up to 1999. Students could perform research to update or add new anatomical developments to the map. They could also choose one of the existing artificial parts—besides the heart—and report to the class any current advances in that area, using Web research.


Pioneers of Heart Surgery is an article recounting how surgeons in World War I pioneered advances that ushered in the age of modern surgery. This article will complement well student's previous experiences in the online operating theater.


Congenital Heart Information Network is dedicated to providing information, support services, and resources to families of children with congenital and acquired heart disease, adults with congenital heart defects, and the professionals who work with them.


The National Heart, Lung, and Blood Institute website is part of and maintained by the National Institutes of Health. It presents generally accepted health information for the public and healthcare professionals. Materials include articles, surveys, studies, recipes for preventing heart disease, and other forms of material relating to varied types of health conditions.


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Lesson Details

Grades Themes Project 2061 Benchmarks National Science Standards State Standards

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