By Patricia Sullivan
Washington Post Staff Writer
Thursday, November 20, 2008
Adrian Kantrowitz, 90, a doctor who performed the first human heart transplant in the United States and developed numerous medical devices that helped save thousands of heart patients, died of complications from congestive heart failure Nov. 14 at the University of Michigan Medical Center in Ann Arbor.
Dr. Kantrowitz transplanted the heart of a brain-dead baby to another infant Dec. 6, 1967, days after Christiaan Barnard had pioneered the operation in South Africa. The American baby died after six hours.
Dr. Kantrowitz had spent years doing the laboratory work and transplanted hearts in 411 dogs in preparation for a human heart transplant, and he was one of a handful of American physicians who expected to do the first transplant. In fact, 18 months before Barnard succeeded, Dr. Kantrowitz had attempted to save a baby with a congenital heart defect by transplanting the heart from a brain-dead infant.
Although he had approval from both sets of parents, at the last minute, two elderly members of his medical team at Maimonides Hospital in Brooklyn prevented him from going forward until the heart of the first baby stopped beating. By the time it did, an hour later, the heart was badly damaged and could not be transplanted.
Dr. Kantrowitz did two more heart transplants before turning away from that field and focusing on his well-known expertise in creating mechanical medical devices.
"I'm a surgeon and surgery is what I know," he told The Washington Post in 1977, explaining his decision to leave the field. "The problems involved in making this work on a broad basis are not surgical problems, they're immunological problems. I do not bring any special talent to solving those problems, nor does my team."
He had led a research team at the Brooklyn hospital that devised a series of innovative devices, starting in the 1950s.
Two of the most influential were the "left ventricular assist device," a battery-operated, mechanical pump-type device that is surgically implanted and helps maintain the pumping ability of a heart that can't function on its own.
He also invented the intra-aortic balloon pump, a balloon and tube that increase blood flow to the heart muscle and decrease the heart's workload through a process called counterpulsation. It can reduce the stress on the heart by as much as 25 percent.
His other inventions included an electronically controlled heart-lung machine in 1958 that allowed successful open-heart surgeries in children. In 1960, Dr. Kantrowitz and Rene Khafif built a large electronic system to deliver electric shocks to the legs of an anesthetized dog that produced walking motions, an important advancement in paralysis treatment. He also developed a miniature radio transmitter emitting signals that caused paralyzed human bladders to empty.
By 1970, amid growing controversy over the ethics of transplants and the inability of the Brooklyn hospital to support advanced cardiac research, Dr. Kantrowitz moved his surgical team to Sinai Hospital in Detroit. He became professor of surgery at the Wayne State University School of Medicine.
He was born Oct. 4, 1918, in New York City to a physician father and a mother who designed costumes for the Ziegfeld Follies. His interest in medical research began as a child through kitchen experiments conducted with his older brother Arthur, according to his papers at the National Library of Medicine.
Dr. Kantrowitz graduated from New York University and received a medical degree in 1943 from what is now known as the State University of New York Downstate Medical School.
Interested in neurosurgery, he proposed and, during his internship, published a paper in the early 1940s on a new type of clamp used during intracranial surgery. During World War II, he was a battalion surgeon in the Army Medical Corps. By the time he was discharged in 1946, few training positions were available in neurosurgery, so Dr. Kantrowitz switched to cardiovascular medicine.
From 1948 to 1955, he worked at Montefiore Hospital in the Bronx and filmed the first of many pioneering research motion pictures, including a color close-up look inside a living dog's heart while the organ was still inside its chest.
In 1955, he moved to SUNY-Downstate in Brooklyn and became director of cardiovascular surgery at the Maimonides Hospital, positions he held for 15 years.
Described by a friend as an engaging maverick, Dr. Kantrowitz was a pilot, sailor and motorcycle rider.
Survivors include his wife of 60 years, Jean Kantrowitz of Lake Angelus, Mich.; three children, Dr. Niki Kantrowitz of Brooklyn, Dr. Lisa Kantrowitz of Newport Beach, Calif., and Dr. Allen Kantrowitz of Williamstown, Mass.; and nine grandchildren.
After moving to Detroit in 1970, Dr. Kantrowitz and his wife co-founded L.VAD Technology Inc., a research and development company specializing in cardiovascular devices. In 2003, at 85 years old, he was still trying to improve cardiac care, seeking FDA approval for a permanent left ventricular assist device.
"When we first did it, people thought it was silly," Dr. Kantrowitz told Crain's Detroit Business newspaper. "You really don't have a good idea unless people think it's silly."