Michael E. DeBakey and Denton A. Cooley— Mike, the Master Assembler;Denton, the Courageous Fighter: A Personal Overview Unforgettable Past Remembrances in the 1960s

摘要

Domingo S. Liotta discovered Assisted Circulation at the Department of Surgery of Baylor College of Medicine in Houston in 1961 and opened up a new medical therapy: Prolonged mechanical Cardiocirculatory Assistance (LVASs) for the treatment of Refractory and Irreversible Heart Failure. The American Society of Cardiology selected Liotta’s work for the “Young Investigator Award” granted in Denver in May 1962: ”This prolonged left ventricular bypass decompresses the left ventricle, reduces left ventricular work, decreases left ventricular wall tension and increases coronary circulation” (D. Liotta, D. A. Cooley, M. E. DeBakey et al. Prolonged assisted circulation during and after cardiac or aortic surgery: prolonged partial left ventricular bypass by means of intracorporeal circulation (Am J Cardiol 1963;12: 399-405). Indeed, there is a lucky occurrence in science;I had the good luck to start this research at a moment when initially unrelated developments were actively taking place in cardiac surgery, long before any rigor or fine statistics were produced. The first observation was to recognize an interaction between the overstretched myocardial fibers and the result of cardiac assistance causing their shortening within the normal values when the excess of blood volume retained in the heart chamber was unloaded, and the second one was that the oxygen consumption of the heart (a measurement of its energy use) decreases during Cardiac Assistance. With the collaboration of Michael E. DeBakey, Liotta started the clinical experience of Cardiocirculatory Assistance and on August 6 1966 they succeeded in the first survival of a patient in postcardiotomy cardiogenic shock. Today, after 50 years, LVASs are in force in the medical practice worldwide and contrarily to transplantation practices, they have an unlimited future;they are continuously fed back by the scientific advances of general technologies. On April 4 1969 Cooley and Liotta implanted the first clinical Total Artificial Heart (TAH) as a bridge to heart transplantation. So far, this has been the case of TAH use in which the patient could be extubated and weaned off the ventilator the following morning. This is a sort of historical document. The venerable visit of Mike DeBakey to Argentina in 1996 was evidence of his majestic peace harmonized in the memory and veracity of useful years.