Adrian Kantrowitz
Encyclopedia
Adrian Kantrowitz was an American
cardiac surgeon
who performed the world's first pediatric heart transplant at Maimonides Medical Center
in Brooklyn
on December 6, 1967. It was only the second time that a human heart had been transplanted into another human being, taking place just three days after Christiaan Barnard
's seminal attempt in South Africa
made headlines around the world and ushered in a new era in clinical organ transplantation. Kantrowitz also invented the intra-aortic balloon pump
(IABP), a left ventricular assist device (L-VAD), and an early version of the implantable pacemaker.
. He told his mother as a three-year old that he wanted to be a doctor, and as a child built an electrocardiograph from old radio parts together with his brother.
in 1940, having majored in math. He attended the Long Island College of Medicine (now SUNY Downstate Medical Center
) and was awarded his medical degree in 1943 as part of an effort to accelerate the availability of physicians during World War II
. During an internship at the Jewish Hospital of Brooklyn, he developed an interest in neurosurgery
, and had a paper published in 1944 paper, "A Method of Holding Galea Hemostat
s in Craniotomies", in which he proposed a new type of clamp to be used while performing a craniotomy
during brain surgery.
He served for two years as a battalion surgeon in the United States Army Medical Corps. Kantrowitz was discharged from the Army in 1946 with the rank of major.
After his military service, he switched to specialize in cardiac surgery
due to the paucity of positions in neurosurgery. In 1947, he was an Assistant Resident
in Surgery at Mount Sinai Hospital
in Manhattan
.
before becoming Chief Resident in Surgery. At the New York Academy of Medicine
, on October 16, 1951, he screened the world's first movies taken inside a living heart, showing the sequential opening and closing of the mitral valve
inside a beating heart. Using dogs and other animals as experimental subjects, Kantrowitz developed an artificial left heart, an early version of an oxygen generator for use as a component in a heart-lung machine
and a treatment for coronary artery disease in which blood vessels would be rearranged during surgery. He also developed a device that allowed individuals who were paralyzed to have their bladders empty through a signal sent from a radio-controlled device.
in Brooklyn. In February 1958, a heart-lung machine
Kantrowitz had developed was used during open heart surgery
on a six-year-old boy while the surgeons repaired a one-inch hole between the chambers of the boy's heart that was present since birth. In an October 1959 lecture at the American College of Surgeons
, Kantrowitz and colleague Dr. William M. P. McKinnon reported on a procedure in which a portion of muscle from the diaphragm
was used to create a "booster" heart to help pump blood in a dog, taking over as much as 25% of the pumping burden of the natural heart. The booster heart functions by receiving a signal sent by a radio transmitter triggered by the pulse of the natural heart. Kantrowitz noted that the procedure was not ready to be performed on humans. Ruff, a "friendly dog of unknown ancestry" was honored by the New York Academy of Sciences
as "research dog of the year" for his unwitting participation in the implantation of a booster heart 18 months earlier in a procedure performed by Kantrowitz.
In the early 1960s, Kantrowitz developed an implantable artificial pacemaker
together with General Electric
. The first of these pacemakers was implanted in May 1961. The device included an external control unit that could adjust the pacing rate from 64 to 120 beats per minute to allow the patient to deal with physical or emotional stress.
Throughout the 1960s, he collaborated with a team that included his brother, engineer Arthur Kantrowitz
, on the development of a left ventricular assist device. Building on his experiments with dogs, he performed the world's second permanent partial mechanical heart implantation in a human on February 4, 1966, which was successful, though the patient died 24 hours after surgery as a result of preexisting liver disease. His second implant of a partial mechanical heart on a 63-year old woman, on May 18, 1966, lasted 13 days, until the patient died of a stroke. During these almost two weeks after the surgery, the patient was improving, and was able to sit up and eat well. This surgery used a valveless device developed with his brother Arthur in which the natural electrical impulses of the patient's heart controlled the action of the pump.
In what turned out to be a race with South Africa
n cardiac surgeon, Dr. Christiaan Barnard
, Kantrowitz prepared for a potential human heart transplant by transplanting hearts in 411 dogs over a five-year period together with members of his surgical team. Barnard performed the first human-to-human heart transplant on December 3, 1967.
On December 6, 1967, Kantrowitz performed the first human heart transplant in the United States, removing the heart of a brain-dead baby and implanting it into the chest of a 19-day-old infant who had a heart defect that would have been fatal. The recipient lived for a little more than six hours after the surgery.
The intra-aortic balloon pump
was invented by Adrian Kantrowitz, working in conjunction with his brother, Arthur Kantrowitz
. Inserted through the patient's thigh, it was directed into the aorta
, and alternately expanded and contracted in order to reduce strain on the heart. Based on Kantrowitz's theory of "counterpulsation", the device inflated the balloon with helium gas when the heart relaxed and deflated it when the heart pumped blood. The pump did not require surgery and could be inserted using local anesthetic in an emergency room or at a patient's bedside. The device was first used in August 1967 to save the life of a 45-year-old woman who was having a heart attack. The device could be used in the 15% of heart attack patients who went into severe shock, 80% of whom could not be helped by the protocols that existed before the balloon pump. Since the device went into widespread use in the 1980s, it had been used in some three million patients by the time of his death.
) in Detroit in 1970, where he assumed the position of attending surgeon and Chairman of the Department of Surgery.
At Sinai Hospital, Kantrowitz experimented further with heart transplants and continued development of the balloon pump, and partial mechanical hearts. In August 1971, he implanted an artificial heart booster in a 63-year-old man whose weakened heart could not pump sufficient oxygenated blood to his body. The patient became the first partial mechanical heart patient to be sent home, and died three months after the surgery.
Kantrowitz died at age 90 in Ann Arbor, Michigan
on November 14, 2008 of heart failure.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
cardiac surgeon
Cardiac surgeon
A cardiac surgeon is a surgeon who performs cardiac surgery—operative procedures on the heart and great vessels.-Training:A cardiac surgery residency typically comprises anywhere from six to nine years of training to become a fully qualified surgeon...
who performed the world's first pediatric heart transplant at Maimonides Medical Center
Maimonides Medical Center
Maimonides Medical Center is a non-profit, non-sectarian hospital located in Borough Park, Brooklyn. Maimonides is both a treatment facility and academic medical center with 705 beds, and more than 70 primary care and sub-specialty programs...
in Brooklyn
Brooklyn
Brooklyn is the most populous of New York City's five boroughs, with nearly 2.6 million residents, and the second-largest in area. Since 1896, Brooklyn has had the same boundaries as Kings County, which is now the most populous county in New York State and the second-most densely populated...
on December 6, 1967. It was only the second time that a human heart had been transplanted into another human being, taking place just three days after Christiaan Barnard
Christiaan Barnard
Christiaan Neethling Barnard was a South African cardiac surgeon who performed the world's first successful human-to-human heart transplant.- Early life :...
's seminal attempt in South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
made headlines around the world and ushered in a new era in clinical organ transplantation. Kantrowitz also invented the intra-aortic balloon pump
Intra-aortic balloon pump
The Intra-aortic balloon pump ' is a mechanical device that increases myocardial oxygen perfusion while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery...
(IABP), a left ventricular assist device (L-VAD), and an early version of the implantable pacemaker.
Biography
Kantrowitz was born in New York City on October 4, 1918. His mother was a costume designer and his father ran a clinic in the BronxThe Bronx
The Bronx is the northernmost of the five boroughs of New York City. It is also known as Bronx County, the last of the 62 counties of New York State to be incorporated...
. He told his mother as a three-year old that he wanted to be a doctor, and as a child built an electrocardiograph from old radio parts together with his brother.
Education and military service
He graduated from New York UniversityNew York University
New York University is a private, nonsectarian research university based in New York City. NYU's main campus is situated in the Greenwich Village section of Manhattan...
in 1940, having majored in math. He attended the Long Island College of Medicine (now SUNY Downstate Medical Center
SUNY Downstate Medical Center
The State University of New York Health Science Center at Brooklyn, better known as SUNY Downstate Medical Center, is a public university and medical center located in central Brooklyn, New York and the only academic center for health education, research, and patient care serving Brooklyn’s 2.5...
) and was awarded his medical degree in 1943 as part of an effort to accelerate the availability of physicians during World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
. During an internship at the Jewish Hospital of Brooklyn, he developed an interest in neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, and had a paper published in 1944 paper, "A Method of Holding Galea Hemostat
Hemostat
A hemostat , is a vital surgical tool used in almost any surgical procedure, usually to control bleeding. Therefore, it is not uncommon to see the initial incision lined with hemostats closing blood vessels awaiting ligation during the initial phases of surgery...
s in Craniotomies", in which he proposed a new type of clamp to be used while performing a craniotomy
Craniotomy
A craniotomy is a surgical operation in which a bone flap is temporarily removed from the skull to access the brain. Craniotomies are often a critical operation performed on patients recording, brain imaging, and for neurological manipulations such as electrical stimulation and chemical...
during brain surgery.
He served for two years as a battalion surgeon in the United States Army Medical Corps. Kantrowitz was discharged from the Army in 1946 with the rank of major.
After his military service, he switched to specialize in cardiac surgery
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
due to the paucity of positions in neurosurgery. In 1947, he was an Assistant Resident
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
in Surgery at Mount Sinai Hospital
Mount Sinai Hospital, New York
Mount Sinai Hospital, founded in 1852, is one of the oldest and largest teaching hospitals in the United States. In 2011-2012, Mount Sinai Hospital was ranked as one of America's best hospitals by U.S...
in Manhattan
Manhattan
Manhattan is the oldest and the most densely populated of the five boroughs of New York City. Located primarily on the island of Manhattan at the mouth of the Hudson River, the boundaries of the borough are identical to those of New York County, an original county of the state of New York...
.
Montefiore Hospital
He was on the surgical staff of Montefiore Hospital in the Bronx from 1948 until 1955. He started at Montefiore as Assistant Resident in Surgery and Pathology, and progressed to Cardiovascular Research FellowFellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...
before becoming Chief Resident in Surgery. At the New York Academy of Medicine
New York Academy of Medicine
The New York Academy of Medicine was founded in 1847 by a group of leading New York City metropolitan area physicians as a voice for the medical profession in medical practice and public health reform...
, on October 16, 1951, he screened the world's first movies taken inside a living heart, showing the sequential opening and closing of the mitral valve
Mitral valve
The mitral valve is a dual-flap valve in the heart that lies between the left atrium and the left ventricle...
inside a beating heart. Using dogs and other animals as experimental subjects, Kantrowitz developed an artificial left heart, an early version of an oxygen generator for use as a component in a heart-lung machine
Heart-lung machine
Cardiopulmonary bypass is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump"...
and a treatment for coronary artery disease in which blood vessels would be rearranged during surgery. He also developed a device that allowed individuals who were paralyzed to have their bladders empty through a signal sent from a radio-controlled device.
Maimonides Medical Center
From 1955 to 1970, he held surgical posts at Maimonides Medical CenterMaimonides Medical Center
Maimonides Medical Center is a non-profit, non-sectarian hospital located in Borough Park, Brooklyn. Maimonides is both a treatment facility and academic medical center with 705 beds, and more than 70 primary care and sub-specialty programs...
in Brooklyn. In February 1958, a heart-lung machine
Heart-lung machine
Cardiopulmonary bypass is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump"...
Kantrowitz had developed was used during open heart surgery
Open Heart Surgery
Open Heart Surgery was released on August 8, 2000 by rock band Virginwool. The band signed to Breaking/Atlantic Records after initially beginning signed to Universal Records. The album was produced and mixed by Brad Wood....
on a six-year-old boy while the surgeons repaired a one-inch hole between the chambers of the boy's heart that was present since birth. In an October 1959 lecture at the American College of Surgeons
American College of Surgeons
The American College of Surgeons is an educational association of surgeons created in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.-Membership:...
, Kantrowitz and colleague Dr. William M. P. McKinnon reported on a procedure in which a portion of muscle from the diaphragm
Thoracic diaphragm
In the anatomy of mammals, the thoracic diaphragm, or simply the diaphragm , is a sheet of internal skeletal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity from the abdominal cavity and performs an important function in respiration...
was used to create a "booster" heart to help pump blood in a dog, taking over as much as 25% of the pumping burden of the natural heart. The booster heart functions by receiving a signal sent by a radio transmitter triggered by the pulse of the natural heart. Kantrowitz noted that the procedure was not ready to be performed on humans. Ruff, a "friendly dog of unknown ancestry" was honored by the New York Academy of Sciences
New York Academy of Sciences
The New York Academy of Sciences is the third oldest scientific society in the United States. An independent, non-profit organization with more than members in 140 countries, the Academy’s mission is to advance understanding of science and technology...
as "research dog of the year" for his unwitting participation in the implantation of a booster heart 18 months earlier in a procedure performed by Kantrowitz.
In the early 1960s, Kantrowitz developed an implantable artificial pacemaker
Artificial pacemaker
A pacemaker is a medical device that uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart...
together with General Electric
General Electric
General Electric Company , or GE, is an American multinational conglomerate corporation incorporated in Schenectady, New York and headquartered in Fairfield, Connecticut, United States...
. The first of these pacemakers was implanted in May 1961. The device included an external control unit that could adjust the pacing rate from 64 to 120 beats per minute to allow the patient to deal with physical or emotional stress.
Throughout the 1960s, he collaborated with a team that included his brother, engineer Arthur Kantrowitz
Arthur Kantrowitz
Arthur Robert Kantrowitz was an American scientist, engineer, and educator.Kantrowitz grew up in The Bronx, and graduated from DeWitt Clinton High School. He earned his B.S., M.A. and, in 1947, his Ph.D. degrees in physics from Columbia University...
, on the development of a left ventricular assist device. Building on his experiments with dogs, he performed the world's second permanent partial mechanical heart implantation in a human on February 4, 1966, which was successful, though the patient died 24 hours after surgery as a result of preexisting liver disease. His second implant of a partial mechanical heart on a 63-year old woman, on May 18, 1966, lasted 13 days, until the patient died of a stroke. During these almost two weeks after the surgery, the patient was improving, and was able to sit up and eat well. This surgery used a valveless device developed with his brother Arthur in which the natural electrical impulses of the patient's heart controlled the action of the pump.
In what turned out to be a race with South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
n cardiac surgeon, Dr. Christiaan Barnard
Christiaan Barnard
Christiaan Neethling Barnard was a South African cardiac surgeon who performed the world's first successful human-to-human heart transplant.- Early life :...
, Kantrowitz prepared for a potential human heart transplant by transplanting hearts in 411 dogs over a five-year period together with members of his surgical team. Barnard performed the first human-to-human heart transplant on December 3, 1967.
On December 6, 1967, Kantrowitz performed the first human heart transplant in the United States, removing the heart of a brain-dead baby and implanting it into the chest of a 19-day-old infant who had a heart defect that would have been fatal. The recipient lived for a little more than six hours after the surgery.
The intra-aortic balloon pump
Intra-aortic balloon pump
The Intra-aortic balloon pump ' is a mechanical device that increases myocardial oxygen perfusion while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery...
was invented by Adrian Kantrowitz, working in conjunction with his brother, Arthur Kantrowitz
Arthur Kantrowitz
Arthur Robert Kantrowitz was an American scientist, engineer, and educator.Kantrowitz grew up in The Bronx, and graduated from DeWitt Clinton High School. He earned his B.S., M.A. and, in 1947, his Ph.D. degrees in physics from Columbia University...
. Inserted through the patient's thigh, it was directed into the aorta
Aorta
The aorta is the largest artery in the body, originating from the left ventricle of the heart and extending down to the abdomen, where it branches off into two smaller arteries...
, and alternately expanded and contracted in order to reduce strain on the heart. Based on Kantrowitz's theory of "counterpulsation", the device inflated the balloon with helium gas when the heart relaxed and deflated it when the heart pumped blood. The pump did not require surgery and could be inserted using local anesthetic in an emergency room or at a patient's bedside. The device was first used in August 1967 to save the life of a 45-year-old woman who was having a heart attack. The device could be used in the 15% of heart attack patients who went into severe shock, 80% of whom could not be helped by the protocols that existed before the balloon pump. Since the device went into widespread use in the 1980s, it had been used in some three million patients by the time of his death.
Sinai Hospital
He and his entire team of surgeons, researchers, biomedical engineers, and nurses relocated to Sinai Hospital (now Sinai-Grace HospitalSinai-Grace Hospital
DMC Sinai-Grace Hospital is the largest hospital in the eight hospitals/institutions composing the Detroit Medical Center. Located in northwest Detroit, Sinai-Grace offers a comprehensive heart center, cancer care, gerontology, emergency medicine, obstetrics/gynecology and cosmetic/plastic surgery...
) in Detroit in 1970, where he assumed the position of attending surgeon and Chairman of the Department of Surgery.
At Sinai Hospital, Kantrowitz experimented further with heart transplants and continued development of the balloon pump, and partial mechanical hearts. In August 1971, he implanted an artificial heart booster in a 63-year-old man whose weakened heart could not pump sufficient oxygenated blood to his body. The patient became the first partial mechanical heart patient to be sent home, and died three months after the surgery.
Personal
Kantrowitz married Jean Rosensaft on November 25, 1948. His wife was an administrator on the surgical research laboratories at Maimonides Medical Center while he was there. In 1983, they co-founded L.VAD Technology, Inc., a company specializing in research and development of cardiovascular devices, with Dr. Kantrowitz as president and his wife as vice president.Kantrowitz died at age 90 in Ann Arbor, Michigan
Ann Arbor, Michigan
Ann Arbor is a city in the U.S. state of Michigan and the county seat of Washtenaw County. The 2010 census places the population at 113,934, making it the sixth largest city in Michigan. The Ann Arbor Metropolitan Statistical Area had a population of 344,791 as of 2010...
on November 14, 2008 of heart failure.
External links
- AP Obituary
- Adrian Kantrowitz Papers (1944-2004) - National Library of Medicine finding aid
- The Adrian Kantrowitz Papers - Profiles in Science, National Library of Medicine