LOUISVILLE — The prognosis for the first recipient of a self-contained artificial heart is guarded, his doctor said Tuesday, nine days after the man suffered a debilitating stroke.

Tools

        Robert Tools had a hole cut in his throat by doctors Tuesday at Jewish Hospital so a ventilator tube could be inserted directly into his windpipe, doctors said. The procedure, called a tracheotomy, lets doctors remove the ventilator from his mouth to make him more comfortable.

        Mr. Tools, 59, of Franklin, Ky., suffered a major stroke Nov. 11 at the hospital, prompting doctors to put him back on the breathing machine a week ago.

        “I feel his prognosis is guarded and it is too premature to make any speculation,” said Dr. Laman Gray Jr., one of the University of Louisville surgeons who implanted the AbioCor artificial heart into Mr. Tools' chest July 2 at Jewish Hospital.

        Mr. Tools' neurologist said Tuesday that bleeding and swelling in Mr. Tools' brain were detected in a follow-up CT scan. She said the conditions can be common after a stroke and did not cause a “significant clinical change” in Mr. Tools.

        “There was some hemorrhage into the original stroke, but there was no evidence of a new stroke,” said Dr. Lynn Simon. “The small amount of hemorrhage was not unexpected with the kind of stroke” that Mr. Tools had.

        Mr. Tools has been sleeping a lot, but he wakes up when his name is called, Dr. Gray said. He was returned to the ventilator because a buildup of secretions in his throat caused him problems swallowing, doctors said.

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