Christiaan Barnard, 78, the South African surgeon who became an international celebrity when he performed the world's first heart transplant in 1967, died of an asthma attack Sept. 1 at a resort on the southwestern coast of Cyprus.
He collapsed in the morning while he was sitting by a swimming pool at the Coral Bay Hotel in the town of Paphos. He was pronounced dead at the town's hospital.
Dr. Barnard, a native of South Africa, was a frequent visitor to Paphos, which made him a freeman of the town this year.
In Johannesburg, former South African president Nelson Mandela said he was deeply saddened.
"I received this news with great shock because he was one of our main achievers, a pioneer in heart transplant. And he also has done very well in expressing his opinion on . . . apartheid."
South African President Thabo Mbeki hailed Dr. Barnard for "scientific excellence and humanism."
"I think really he ought to serve as an inspiration to our people, to the youth generally, to strive for that discovery, that excellence," Mbeki told Reuters.
Dr. Barnard performed the world's first heart transplant at Groote Schuur Hospital in Cape Town on Dec. 3, 1967. The patient, grocer Louis Washkansky, 53, lived 18 days before succumbing to rejection of the new heart.
The transplant transformed Dr. Barnard into an international celebrity. He received awards from around the world and was entertained by glitterati such as Princess Grace of Monaco and Princess Diana of Britain.
"We really did not see it as a big event," Dr. Barnard told the Associated Press in 1997. "We did not even take photographs of the operation that night."
After Washkansky died, Dr. Barnard and his team persevered with their innovative surgical procedure. His second transplant patient, Philip Blaiberg, lived for 18 months after the operation, and the survival time of patients has increased since.
Today, 90 percent of patients survive a heart-transplant operation and have an 85 percent chance of living for a year and a 70 percent to 75 percent chance of lasting five years.
Dr. Barnard's longest-surviving patient, Dirk van Zyl, lived with an implanted heart for 23 years before dying in 1996 of diabetes unrelated to his heart condition.
In a 1993 autobiography, Dr. Barnard revealed how he was "consumed and intoxicated" with fame after his 1967 operation.
His face adorned the cover of Time and other international magazines; television networks scrambled for interviews; and the Guinness Book of Records once claimed he received more fan mail than anyone on earth.
The handsome surgeon enjoyed a playboy existence, partying with the likes of Sophia Loren, Audrey Hepburn and Richard Burton.
Dr. Barnard had said his big regret was turning away a Hollywood agent at the height of his fame and not cashing in.
He moved to Austria but traveled abroad for business and the lecture circuit, on which he was paid up to $10,000 a speech.
Dr. Barnard's father was a Calvinist preacher in Beaufort West, a dusty town 250 miles north of Cape Town. The future surgeon studied medicine at the University of Cape Town, but his medical career was nearly aborted when he became nauseated watching an operation for the first time.
After completing his internship at Groote Schuur, he married nurse Alletta Gertruida Louw in 1948 and went into practice in Ceres, a mountain village 70 miles north of Cape Town.
In 1951, he returned to Cape Town, where he became a senior medical officer at Groote Schuur, before heading to the United States to work at the University of Minnesota under the tutelage of renowned heart surgeons Richard Varco and C. Walton Lillehei.
Dr. Barnard returned to Groote Schuur and took over the University of Cape Town's cardiothoracic surgery department in 1961, developing a technique to correct the infant cardiac killer known as "transportation of the great vessels" and successfully performing several pioneering heart operations.
Before performing surgery on Washkansky in 1967, Dr. Barnard had spent many years experimenting with heart transplants, operating mainly on dogs.
He also had performed the first successful open-heart operation in South Africa.
Dr. Barnard was criticized after Washkansky's and other early operations for performing the transplants before enough was known about preventing organ rejection to keep patients alive.
But he said that Washkansky, who had diabetes and incurable heart disease, had faced certain death without the operation and was aware of what he faced.
"For a dying man, it is not a difficult decision, because he knows he is at the end. If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side. But you would never accept such odds if there were no lion," Dr. Barnard wrote.
He said the highlight of his career was performing operations on children with abnormal hearts, each operation requiring different techniques and skills.
"That was real surgery," he said.
He retired from teaching in the 1980s after performing 75 transplants. He was head of the Chris Barnard Foundation, established in 1998 to promote pediatric medicine throughout the world.
Dr. Barnard wrote several books, including a medical thriller called "The Donor." His last book, published this year, was "50 Ways to a Healthy Heart."
Rheumatoid arthritis forced him to give up surgery in 1983. He spent his last years writing, consulting, giving lectures and dividing his time between Europe and his farm in South Africa's Cape Province.
Last year, Dr. Barnard teamed up with heart surgeon Susan Vosloo to give a lifesaving operation to a 13-month-old boy from Zimbabwe. He had met the child while he was in Harare to give money to AIDS orphans.
A man who never shied from controversy in apartheid-era South Africa, Dr. Barnard ignored many racial barriers in the country. He was the first doctor to use mixed-race nurses in the operating room to treat white patients, and he transplanted the heart of a white woman into a black man.
Yet he also criticized apartheid opponents for not recognizing the good in his country.
His three marriages ended in divorce. He had six children.