Ann Thorac Surg 2005;79:S2257-S2259
© 2005 The Society of Thoracic Surgeons
Supplement
Lillehei Heart Institute Lifetime Achievement Awards
R. Morton Bolman, III, MD*
C. Walton and Richard C. Lillehei Professor and Chief, Division of Cardiovascular and Thoracic Surgery, Lillehei Heart Institute, University of Minnesota, Minneapolis, Minnesota
Accepted for publication February 4, 2005.
* Address reprint requests to Ms Dee McManus, Lillehei Heart Institute, University of Minnesota, MMC #195, Minneapolis, MN55455 (E-mail: d-mcma{at}umn.edu).
Presented at the 4th Annual Lillehei Heart Institute Symposium Celebrating the 50th Anniversary of Open-Heart Surgery by Cross Circulation, Minneapolis, MN, Oct 19–20, 2004.
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Introduction
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The Lillehei Heart Institute honored 11 individuals who have made seminal contributions to the development of the field of heart surgery during the 50th Anniversary of Open-Heart Surgery by Cross Circulation celebrated at the University of Minnesota on October 19th and 20, 2004. During the past 50 years, so many people have contributed to the remarkable progress in open-heart surgery, and the Lillehei Heart Institute presented Lifetime Achievement Awards to these 11 individuals to signify a special place in this pantheon of research and discovery.
Each of these people is so accomplished that books could be written about them, but this discussion will only be able to touch on highlights of each individual’s life.
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Earl Bakken
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The first recipient of a Lifetime Achievement Award is a Minnesotan who not only makes a difference in the health of 2.5 million people annually who receive pacemakers, but who also strives to improve the lives and health of those in the Hawaiian community where he now lives. Earl Bakken trained as an electrical engineer at the University of Minnesota—but what he truly is, is a visionary. With his brother-in-law in 1949, Mr Bakken founded Medtronic—a company that only really took off after Mr Bakken established a connection with C. Walton Lillehei in October 1957. Walt asked him to make a better pacemaker than the alternating current pacemakers then in use. Within 4 weeks, Bakken produced a small, self-contained, transistorized, battery-powered pacemaker that could be taped to the patient’s chest. It was tested, and the very next day, the pacemaker was used in the hospital on the first patient. That product has been continually improved, and today Medtronic is a leader in the medical technology field and the world’s largest manufacturer of cardiac pacemakers.
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Aldo R. Castañeda
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Aldo Castaneda’s fellowship in surgery at the University of Minnesota was the beginning of a 14-year association with this university. He studied with Drs C. Walton Lillehei and Richard Varco on the way to earning his PhD in experimental surgery in 1963. That same year, Dr Castaneda finished his surgical training and was appointed instructor at the University of Minnesota. Because of his stellar achievements as a surgeon, teacher, and researcher, he advanced in only 7 years from instructor to professor of surgery. In 1972, he left Minnesota to assume the positions of Professor of Surgery at Harvard Medical School and Cardiovascular Surgeon-in-Chief at Children’s Hospital Boston. He envisioned new heart operations for children with congenital heart disease and helped develop methods to repair hearts as early in life as possible. In 1975 he became William E. Ladd Professor of Child Surgery at Harvard Medical School, and in 1981 assumed the position of Surgeon-in-Chief of the Children’s Hospital. He served in the positions until his retirement in 1995. Since his retirement to Guatemala, he has built there a major pediatric heart center, for which he was recognized with the World Heart Foundation 2004 Humanitarian Award.
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Morley Cohen
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Morley Cohen earned his MD from the University of Manitoba in 1948 and was accepted by the Graduate School of the University of Minnesota in 1950. He began work in the research laboratory on ways to oxygenate blood, to develop methods to permit open heart surgery. In 1953, there was an astonishing breakthrough with the discovery of the azygos flow concept leading to the dog lung self-oxygenator. Later that same year, Cohen and his fellow student, Herbert Warden, accomplished cross circulation. In 1955, former President Harry S. Truman presented the American Public Health Association’s Albert Lasker Award to Cohen, C. Walton Lillehei, Richard Varco, and Warden for "development of methods of open-heart surgery." Doctor Cohen returned to Winnipeg in 1955 and joined the faculty of the University of Manitoba. He continued to carry out research and performed the first open heart surgery in Manitoba in 1959. Later, he was named head of their newly formed Cardiovascular and Thoracic Surgery Section, and, after a training program in this new specialty was approved by the Royal College of Physicians and Surgeons of Canada, he trained surgeons who live in Canada and beyond its borders.
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Richard DeWall
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Born in Appleton, Minnesota, Richard DeWall earned five degrees at the University of Minnesota—a BA in 1949, a BS in 1950, an MB in 1952, an MD in 1953, and an MS in 1961. Working with Drs Varco and Lillehei, he became a research assistant in the Department of Surgery in 1953 and a resident in 1954. Doctor DeWall developed a heart-lung machine, the deceptively simple bubble oxygenator that would, beginning in 1955, replace cross circulation during Lillehei’s open heart operations and revolutionize the field worldwide. After completing his residency in 1961, Dr DeWall joined the university’s faculty. He left in 1962 to chair the Department of Surgery at the Chicago Medical School and Mount Sinai Hospital. In 1966, he was appointed Chief of Surgery at the Cox Heart Institute in Kettering, Ohio. He directed the Surgery Residency Training Program at Kettering Medical Center until 1976, and was named clinical director of open-heart surgery there in 1986. One of his proudest accomplishments is that, through his legislative lobbying and endless efforts, the Ohio legislature, in 1973, established the Wright State University School of Medicine in Dayton, Ohio, and graduated its first class in 1980.
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Jesse Edwards
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In 1946, after serving in a war crimes investigation unit during World War II, Jesse Edwards came to the Mayo Clinic. A cardiac pathologist, he described a great deal of the anatomy and physiology of congenital heart defects. When the young surgeon, Walt Lillehei, wanted to know more about these defects, he came to Dr Edwards at Mayo. Doctor Edwards served as a bridge between the University of Minnesota and Mayo, which also was developing its open-heart surgery program at the time. Doctors Edwards and Lillehei became good friends and in 1960, Dr Edwards was given a faculty appointment at the university and moved to the then Miller Hospital, which is now United Hospital. At the university, Dr Edwards taught nearly all the surgeons and led a weekly cardiac pathology conference. At Miller Hospital, he established a registry of cardiovascular disease that has become an outstanding worldwide resource for teaching and for research. Although slowed by declining health in recent years, Dr Edwards continues to work—in 2000, his synopsis of congenital heart disease was published and his book on the pathology of sudden cardiac death is now at the printer.
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Vincent Gott
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After earning his MD at Yale, Vincent Gott came to the University of Minnesota in 1953 for his surgical residency. While a research fellow, he assisted in the development of the oxygenator. His work on the pacemaker was also very important. Patients had been receiving up to 75 V’s, which resulted in pain and blistering until Dr Gott discovered that an electrode placed directly on the heart, with an average current of only 2.2 V, reversed complete heart block. After residency, he joined the University of Minnesota surgery faculty for a year, then moved to the University of Wisconsin. In 1965, Dr Gott joined the faculty at Johns Hopkins University School of Medicine and remained there for 34 years, 17 as Director of the Division of Cardiac Surgery. His accomplishments include development of the Gott shunt, as well as being coinventor of the Gott-Daggett heart valve. His clinical interest in Marfan syndrome has established him as a world leader in surgical repair of aortic diseases. The Vincent L. Gott Professorship has been established at Hopkins in tribute to his patient care and training of more than 60 cardiac surgeons.
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F. John Lewis
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F. John Lewis, who passed away in 1993, was the first surgeon to perform direct-vision open-heart surgery. On September 2, 1952, Lewis, with Richard Varco as his first assistant and Walt Lillehei among his second assistants, corrected an atrial septal defect in a 5-year-old girl under general hypothermia and inflow occlusion. This breakthrough contributed greatly to the subsequent development of open heart surgery using cross circulation. In 1956, Dr Lewis went to Northwestern University to be the first full-time member of the faculty of surgery. In 1976, he left Northwestern abruptly for Santa Barbara, California, where he wrote essays about hiking and mountain climbing, a guide to bicycling in that city, and a book titled So Your Doctor Recommended Surgery.
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C. Walton Lillehei
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C. Walton Lillehei, who served as second assistant in that very first open-heart surgery led by F. John Lewis, would push the field of cardiac surgery into uncharted territory and begin the golden era of this specialty. A native of Minnesota, Lillehei was a daring innovator, but he did not act alone—he collaborated with each of the pioneers whom we honor with these Lifetime Achievement Awards, and many more. He built teams to solve clinical issues, which resulted in discoveries that benefited patients, advanced heart surgery, and created the medical device industry. He made outstanding contributions to the development of pacemakers and heart valves. At the University of Minnesota and at Cornell, where he joined the faculty in 1967, Dr Lillehei trained 154 cardiac surgeons, and it is both remarkable and admirable that more than 800 surgeons from 35 countries can trace their training lineage directly back to Dr Lillehei. It is this legacy that we sustain and enhance at the University of Minnesota’s Lillehei Heart Institute.
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Norman Shumway
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On October 19, 2004, the University of Minnesota presented Dr Norman Shumway with the highest recognition it can bestow—an honorary doctorate. Doctor Shumway was at Minnesota from 1954 to 1957 as a postdoctoral research fellow and then a special trainee of the National Heart Institute. After he moved to Stanford University in 1958, he devoted his efforts to making heart transplants a clinical reality and developed the very successful heart transplant program there. He is widely known as the "father" of heart transplantation. His contributions to cardiac surgery are legion—in research, in clinical care, and in educating surgeons.
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Richard Varco
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The Lifetime Achievement Award of the Lillehei Heart Institute is a tribute to Richard Varco, who passed away in 2004. Allow me to thank Dr Henry Buchwald, who generously shared his insights about Dr Varco. Doctor Varco was one of the world’s best cardiac surgeons at the University of Minnesota. He assisted Walt Lillehei in more than 100 open heart surgeries from 1954 to 1955.
Doctor Varco was the Director of the Thoracic and Cardiovascular Surgery Training program at the University of Minnesota from 1968 to his retirement in 1981. During that interval, his program, started in the infancy of specialized cardiovascular training, became one of the most prestigious and sought-after residencies and fellowships in the country. In 1963, he performed the first organ transplant at the University of Minnesota, a kidney transplant between identical twins. With this case, the world-famous University of Minnesota transplant program was born.
A renaissance surgeon and thinker, Dr Varco excelled not only in cardiovascular surgery but also in gastrointestinal surgery, transplantation, metabolic surgery, and biomedical engineering. He was a superb technical surgeon and role model. What nature left defective or incomplete, he corrected and made whole, and he did it with elegance and grace.
The New York Times noted in its obituary that "Dr Varco was an innovator throughout his career....With Dr Buchwald, he created the first implantable drug-infusion pump, a predecessor of a device that is used today to deliver insulin to diabetics and pain medication to the spinal cord."
Born in Montana, Richard Varco came to Minnesota in his teens and earned his degrees—MB, MD, and PhD, at the University of Minnesota. Richard married Louise during his residency research years. They raised 8 children: Richard, Robert, John, Jim, Charles, Anne (Varco Hochman), Mary, and Catherine (Fisher). He was a beloved grandfather to 18. After his retirement, Richard and Louise had the good fortune to have more than 20 years together in their dream house on a wooded peninsula on Halfmoon Bay in British Columbia until his passing in May 2004.
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Herbert Warden
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Herbert Warden graduated from the University of Chicago, School of Medicine in 1946 and served in the US Navy before coming to the University of Minnesota to complete his surgery training. After arriving in 1951, Warden teamed up with Dr Morley Cohen in the research laboratory of Walt Lillehei. Together, they combined the azygos theory of the low flow necessary to preserve life with the mechanics of biologic lung oxygenation and conceived the medical breakthrough of cross circulation. This technique paved the way toward the open surgical correction of congenital heart defects. After sufficient experimentation, the first procedure using cross circulation on a human was carried out on March 26, 1954. The team that day, consisting of Walt Lillehei, Richard Varco, Cohen, and Warden, was awarded the Albert Lasker Award in 1955 for their part in the development of the methods of open-heart surgery. Doctor Warden accepted a faculty position at the University of Minnesota after completion of his surgical residency. He remained here for 5 years; in 1960, Dr Warden joined the faculty at West Virginia University. He established the school’s heart surgery and surgical training programs and in 1962, led the team which performed the first open heart surgery in the state of West Virginia.
That completes the list of the first recipients of the Lillehei Heart Institute’s Lifetime Achievement Awards. We are grateful for the contributions of so many and look forward in the years ahead to celebrating with this award the accomplishments of other outstanding scientists, surgeons, and other contributors to cardiovascular health.
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Introduction
Earl Bakken