All achievers

Denton A. Cooley, M.D.

Pioneer of Heart Transplants

I think confidence is something you build gradually, with experience. I've always felt that maybe one of the reasons that I did well as a student and made such good grades was because I lacked confidence. I never felt that I was prepared to take an examination, and I had to study a little bit extra.

Denton Cooley was born and raised in Houston, Texas. His father, a dentist, had a thriving practice and was able to invest profitably in real estate. When young Denton first entered school he was shy and insecure, but gained confidence by applying himself to his studies, and by high school had distinguished himself academically and athletically, playing tennis and basketball. At the University of Texas, he majored in zoology, and was a star of the varsity basketball squad. At first he intended to join his father’s dental practice, but after taking a few pre-med courses, he became fascinated by surgery.

The UT Longhorn basketball team, 1939 Southwest Conference Champions. Dr. Cooley located on the top row, far right.
The University of Texas Longhorn basketball team, 1939 Southwest Conference Champions. Dr. Denton Cooley.

In 1941, he entered the Texas College of Medicine at Galveston, but soon transferred to Johns Hopkins in Baltimore. His medical education was provided in part by the Army Specialty Training Program. He obtained his M.D. degree in 1944 and remained at Hopkins as an intern, assisting Dr. Alfred Blalock in the first “blue baby” operation, to correct an infant’s congenital heart defect.

Cooley maintained that the modern era in cardiovascular surgery began with Dr. Blalock’s work, and it inspired him to specialize in heart surgery. Even as an intern, Cooley impressed his colleagues with his extraordinary speed and dexterity in the operating room.

In 1944, pediatric cardiologists Dr. Alfred Blalock and Dr. Helen Taussig figured out a surgical method that dealt with methaemoglobinaemia, or “blue baby syndrome.” At Johns Hopkins, Cooley had been taken under the wing of Blalock. Blalock permitted him to assist in the first surgery to correct the congenital heart defect of a "blue baby," whose malfunctioning heart prevented him from getting adequate oxygen. That experience inspired Cooley to make heart surgery his specialty.
In 1944, Dr. Alfred Blalock and Dr. Helen Taussig figured out a surgical method dealing with “blue baby syndrome.” At Johns Hopkins, Denton Cooley had been taken under the wing of Blalock. Blalock permitted him to assist in the first surgery to correct the congenital heart defect of a “blue baby,” whose malfunctioning heart prevented him from getting adequate oxygen. That experience inspired Dr. Denton Cooley to make heart surgery his specialty.

In 1946, Dr. Cooley was called on to fulfill his obligation to the Army and went on active duty with the Army Medical Corps. He served as chief of surgical services at the station hospital in Linz, Austria and was discharged in 1948 with the rank of captain. He returned to Hopkins to complete his residency and remained as an instructor in surgery. In 1950 he traveled to London to work and study with Lord Russell Brock, the eminent British surgeon.

January 15, 1949: Louise Goldsborough Thomas, R.N., head nurse at Halsted Surgical Clinic at Johns Hopkins Hospital, married Denton A. Cooley, chief surgical resident.
1949: Louise Thomas, R.N., head nurse at Johns Hopkins Hospital, married Denton Cooley, chief surgical resident. Dr. Cooley’s wife of 67 years died in October of 2016. A daughter, Florence Cooley, committed suicide in 1985. Dr. Cooley’s surviving family included four daughters, sixteen grandchildren, and seventeen great-grandchildren.

Dr. Cooley finally came home to Houston in 1951, to become associate professor of surgery at Baylor University College of Medicine and to work at Methodist Hospital, its affiliated institution. At Baylor and Methodist, Cooley began his collaboration with Dr. Michael DeBakey, the great pioneer of vascular surgery. This relationship would lead to great triumphs and to great bitterness for both men.

1957: Dr. Cooley in his office at Baylor. He served on the full-time faculty of Baylor College of Medicine for 18 years as a professor of surgery. (Texas Heart Institute)
1957: Dr. Cooley served on the full-time faculty of Baylor College of Medicine for 18 years as a professor of surgery.

Throughout the ’50s, their collaboration produced great innovations in surgery. While working with DeBakey, Cooley developed a new method of removing aortic aneurysms, the bulging weak spots that may develop in the wall of the artery. Some 20 years earlier, Dr. DeBakey had begun work on a heart-lung bypass machine, to immobilize the heart during surgery, but it was Cooley’s design that was finally used successfully at Methodist Hospital in 1955.

The two great surgeons were temperamentally incompatible, and in 1960, Dr. Cooley moved his practice from Methodist Hospital to St. Luke’s Episcopal Hospital, only 300 feet away. He also worked at Texas Children’s Hospital, and continued to teach at Baylor, where he was now a full professor. Through his work at Baylor, he still came into contact with Dr. DeBakey, and the friction between the two doctors continued. Meanwhile, Dr. Cooley founded the privately funded Texas Heart Institute.

1954-62: Denton A. Cooley M.D., Edward Singleton, M.D. and Dan McNamara, M.D. at Texas Heart Institute.
1954-62: Denton A. Cooley M.D., Edward Singleton, M.D. and Dan McNamara, M.D. at the Texas Heart Institute.

Cooley’s fame spread throughout the 1960s as he applied his extraordinary dexterity to delicate surgery on the hearts of infants with congenital heart disease. He was the first surgeon to successfully remove pulmonary embolisms, squeezing the lungs flat to remove the inaccessible blood clots.

Dr. Cooley and his colleagues also pursued the development of artificial heart valves. From 1962 to 1967, the mortality rate for valve transplant patients fell from 70 percent to eight percent. In 1967, the International Surgical Society awarded Dr. Cooley its highest honor, the Renée Lebiche Prize. In its citation, the Society called him “the most valuable surgeon of the heart and blood vessels anywhere in the world.”

Dr. Christiaan N. Barnard, the South African surgeon who performed the world's first human heart transplant in 1967. In his autobiography, One Life, Barnard wrote about observing Cooley in surgery: “It was the most beautiful surgery I had ever seen... Every movement had a purpose and achieved its aim. Where most surgeons would take three hours, he could do the same operation in one hour. It went forward like a broad river — never obvious in haste, yet never going back... No one in the world, I knew, could equal it.”
Dr. Christiaan N. Barnard, the South African surgeon who performed the world’s first human heart transplant in 1967. In his autobiography, One Life, Barnard wrote about observing Denton Cooley in surgery: “It was the most beautiful surgery I had ever seen… Every movement had a purpose and achieved its aim. Where most surgeons would take three hours, he could do the same operation in one hour… No one in the world, I knew, could equal it.”

At the end of that year, the South African surgeon, Christiaan Barnard, stunned the world by successfully transplanting a human heart. Within days, American surgeons tried and failed to duplicate the operation. Cooley and his team of surgeons at St. Luke’s studied Barnard’s methods with great care, streamlining and perfecting the procedure before trying it on a human patient.

April 4, 1969: Denton A. Cooley, world's first total artificial heart implant at Texas Heart Institute on Good Friday. Dr. Cooley holds in his right hand the Liotta TAH, and in his left, the native heart which has just been removed from the patient's chest (Haskell Karp). The patient was maintained on the TAH for 64 hours until a donor heart was located and transplant was performed.
April 4, 1969: Denton A. Cooley performing the world’s first total artificial heart implant at Texas Heart Institute. Dr. Cooley holds Liotta TAH and the native heart which has just been removed from the patient’s chest. The patient, Haskell Karp, was kept on the TAH for 64 hours until a donor heart was located and the transplant was performed.

On May 3, 1968, Cooley performed his first human heart transplant. The donor was a 15-year-old girl who had committed suicide. Although her brain had ceased to function, her heart was still beating. Cooley successfully transplanted the heart into a 47-year-old man, who survived for 204 days with the transplanted heart. Over the next year, Cooley performed 22 heart transplants, completing three within a single five-day period.

April 10, 1970 cover of LIFE magazine, with photos of Dr. Denton Cooley (top) and Dr. Michael Debakey. (Photo by Ralph Morse/Life Magazine/Time & Life Pictures/Getty Images)
April 10, 1970 cover of LIFE magazine, with photos of Dr. Denton Cooley (top) and Dr. Michael DeBakey. The DeBakey-Cooley imbroglio was in part rooted in this ethical dilemma. In 1969, Dr. Cooley sought to use an artificial heart as a temporary measure while the patient awaited a human heart from a donor. It was never clear how Dr. Cooley obtained the artificial heart developed by Dr. DeBakey, but a member of Dr. Cooley’s surgical team had once worked for Dr. DeBakey. DeBakey, who was out of town when the surgery was performed by Dr. Cooley, felt betrayed and was furious. The episode put federal grants at risk and resulted in Dr. Cooley’s censure by the American College of Physicians. DeBakey said that his onetime colleague “disappointed me with his ethics” and that his actions were “a little childish.” They didn’t speak for almost 40 years before they reconciled in 2007, one year before Dr. DeBakey’s death, at age 99. (Ralph Morse/Life Magazine/Time & Life Pictures/Getty Images)

Cooley’s extraordinary record in these years attracted both praise and criticism. Many Americans did not accept the end of brain activity as the moment of death, and condemned the practice of removing a beating heart for transplant. In 1969, with no donor heart available for his dying patient, Dr. Cooley took a great risk by implanting an experimental artificial heart. After 65 hours, a human heart became available, and Cooley replaced the artificial heart, but the patient died a day later. Dr. Barnard, the pioneer of heart transplantation, praised Cooley’s decision, but Cooley’s former colleague, Dr. DeBakey, was harshly critical.

1994: Dr. Denton Cooley and Dr. Tim Bricker visit with Sara Remington on the ten-year anniversary of her heart transplant. Remington had a heart transplant that cardiologist Dr. Denton Cooley described as "a pilot study" for infant transplants. Baby Sara, as she was called for a time, is the youngest surviving recipient of a new heart. She was only 8 months old when she had the transplant on November 1, 1984, a week after Baby Fae was given a baboon heart in California. A few months earlier, a 10-day-old girl in London became the youngest patient to receive a new heart, but she died 18 days later.
1994: Dr. Denton Cooley and Dr. Tim Bricker visit with Sara Remington on the ten-year anniversary of her heart transplant. Remington had a heart transplant that Cooley described as “a pilot study” for infant transplants. Baby Sara, as she was called for a time, is the youngest surviving recipient of a new heart. She was only 8 months old when she had the transplant on November 1, 1984, a week after Baby Fae was given a baboon heart in California. A few months earlier, a 10-day-old girl became the youngest patient to receive a new heart, but died 18 days later.

Dr. DeBakey believed that Cooley had improperly appropriated DeBakey’s research, and had performed the operation without receiving federal approval for the procedure. Cooley emphatically denied the first charge, and asserted that the patient’s permission was adequate justification to attempt the operation. The governors of the American College of Surgeons voted to censure Dr. Cooley and, after a further dispute with the trustees of Baylor, he ended his 19-year association with the university. A multimillion-dollar malpractice suit brought by the patient’s widow was dismissed by the federal courts.

Reaching a major milestone with Cooley's associates at the Texas Heart Institute: 100,000 open heart operations, January 10, 2001. Standing left to right: Charles Hallman, Grady Hallman, George Reul, O.H. (Bud) Frazier, Jim Livesay, Mike Duncan and David Ott.
2001: Reaching a major milestone with Denton Cooley’s associates at the Texas Heart Institute: 100,000 open heart operations. Charles Hallman, Grady Hallman, George Reul, Bud Frazier, Jim Livesay, Mike Duncan and David Ott.

While Drs. Willem Kolff and William DeVries in Utah continued the development of the artificial heart, Cooley turned his attention to the coronary bypass operation. By 1972, he had performed over 1,200 bypasses; 10,000 open-heart operations, more than any other surgeon in the world.

The establishment of the Denton A. Cooley Cardiovascular Surgical Foundation was seen in 1972 — an organization of surgeons trained by Dr. Cooley — and the dedication of the 29-story Texas Heart Institute building in Houston, where Dr. Cooley performed as many as 25 heart operations in a single day.

Michael E. DeBakey and Denton A. Cooley as DeBakey accepts a lifetime achievement award and honorary membership from the Denton A. Cooley Cardiovascular Surgical Society, October 27, 2007.
October 27, 2007: Dr. Michael E. DeBakey and Dr. Denton A. Cooley at the event where the two reconciled.  Dr. DeBakey accepted a Lifetime Achievement Award from the Denton A. Cooley Cardiovascular Surgical Society.

Dr. Cooley married Louise Goldborough Thomas of Baltimore, and the couple raised five daughters. During his career, Dr. Cooley spent his limited spare time with his family, playing golf and playing upright bass with an all-physician band, The Heartbeats.

Inducted Badge
Inducted in 1968

As late as the 1940s, it was considered impossible to operate on the heart of a living patient. The tremendous advances made in cardiovascular surgery since that time are the work of many great physicians, but in this history, a few great names stick out, including those of Dr. Denton Cooley and Dr. Michael DeBakey.

While still an intern, Dr. Cooley participated in the first “blue baby” operation, to correct the congenital heart defect common in newborns. Early in his career, he pioneered the removal of aortic aneurysms, the replacement of damaged heart valves, and the development of the heart-lung machine. Dr. Cooley went on to perform the first successful human heart transplants in the United States, and was the first surgeon anywhere to implant an artificial heart in a human being.

He performed more open-heart operations than any surgeon in the world, including over 20 human heart transplants. In the middle of his career he became embroiled in controversy with his former colleague, Dr. DeBakey, but no one can dispute that he personally saved tens of thousands of lives, and through the techniques he developed and the surgeons he trained, perhaps a million more.

Watch full interview

Dr. Cooley, what is it about the heart that fascinates you?

Keys to success — Passion

Denton Cooley: It’s really a fascinating organ. It’s about the only organ in the body that you can really witness its function. It’s active and doing things, and so on. Some of the other organs you can witness, like the intestines, will have this sort of peristaltic motion. But nothing can compare with the activity of the human heart. And besides that, it’s always had a special connotation in our society, or in our life. It’s been the seat of the soul, and the seat of emotions. The seat of many things. And so, it has always been considered to be an organ that was not amenable, did not lend itself to manipulation. But now we find that it really is a tough little organ. It can tolerate a great deal, and it certainly has been revealed that it can be corrected in many ways, and even replaced by organ transplantation.

In 1944, you took part in a historic operation with Dr. Alfred Blalock. Describe the circumstances, and what you did.

Denton Cooley: Dr. Blalock and his cardiology colleague, Dr. Helen Taussig, had been trying to find a way to correct “blue baby” syndrome. Dr. Blalock had done experiments in the animal laboratory at Johns Hopkins. I had little to do with those experiments, but I did participate up to a point. When the big day came, there was quite a bit of tension and concern around the surgical suite. I was just an intern, so I felt grateful that I was part of the team. I didn’t fully realize, of course, what an impact this operation would have on the new field of heart surgery. I didn’t appreciate what was happening, but it became evident in the weeks and months that followed, as heart surgery became a thing of interest all over the world. Patients and doctors flocked to Hopkins to see these new techniques. I was 24 years old, but I was right in the middle of history, and I enjoyed the thrill.

In 1944, pediatric cardiologists Dr. Alfred Blalock and Dr. Helen Taussig figured out a surgical method that dealt with methaemoglobinaemia, or “blue baby syndrome.” At Johns Hopkins, Cooley had been taken under the wing of Blalock. Blalock permitted him to assist in the first surgery to correct the congenital heart defect of a "blue baby," whose malfunctioning heart prevented him from getting adequate oxygen. That experience inspired Cooley to make heart surgery his specialty.
In 1944, Dr. Alfred Blalock and Dr. Helen Taussig figured out a surgical method dealing with “blue baby syndrome.” At Johns Hopkins, Denton Cooley had been taken under the wing of Blalock. Blalock permitted him to assist in the first surgery to correct the congenital heart defect of a “blue baby,” whose malfunctioning heart prevented him from getting adequate oxygen. That experience inspired Dr. Denton Cooley to make heart surgery his specialty.

The mortality rate for “blue babies” was fairly high before this, wasn’t it?

Denton Cooley: By today’s standards, it was quite high, but we didn’t have all of the facilities available to us then that we have today. Some of those experiences were very discouraging to me.

Keys to success — Perseverance

I can remember so well, one day when we lost a patient in the operating room. Lost one of the patients back on the cardiac ward, and so forth, and I was very depressed. I went and talked to Dr. Blalock, and I said we ought to cancel the schedule for the rest of the week, and sort of get ourselves back together. And he said, “No. We didn’t do anything wrong. We did our best.” He said, “You just go ahead and schedule tomorrow’s cases as if nothing had gone wrong.” He said, “I think I’m going to go out and play nine holes of golf myself.” And that was a good lesson to me, you know. The only way you can get over this discouragement, or sadness, is to keep on working. The human mind has a way of putting some of those things in a distant corner, and you just go ahead with your life, and try to overcome those disappointments.

I imagine that could drag you down, if you let it.

Denton Cooley: That’s right. But it’s part of the game. I still take failure very seriously, but I’ve found that the only way I could overcome the feeling is to keep on working, and trying to benefit from failures or disappointments. There are always some lessons to be learned. So I keep on working.

The Jefferson Davis Hospital house staff (residents and interns) and medical staff. Cooley is standing next to Mike DeBakey (end of second row, right).
The Jefferson Davis Hospital house residents, interns and medical staff. Cooley is standing next to Mike DeBakey.

I read about another dramatic event from that early period. When you were an intern, you had to act very quickly to repair an aorta that had ruptured during an operation. Can you describe that experience?

Keys to success — Courage

Denton Cooley: I was operating with a surgeon who himself was handicapped. He had had a spinal cord tumor. He had one good hand, which was I think his left hand, which he used to operate. And he had one other arm, that was in sort of a brace. We had a patient with an aneurysm here, just under his breast bone. And I remember so well, we got the man anesthetized — he was actually bleeding when he got in the operating room — had the man anesthetized, and this surgeon reached down and pulled up the breast bone, and the blood hit the ceiling, and he put his finger in the hole in the aorta, and so he was completely immobilized. Because he had this other arm that he couldn’t do much with, and so he said, “Cooley, it’s your operation now. See what you can do to get my finger out of the hole.” And that was the way that came about. I figured out a way to patch up the hole in the aorta, and the patient survived. But I remember it was a task that was way beyond my experience at the time. And I wasn’t prepared for anything that difficult.

You were just an intern when this happened?

Denton Cooley: Yes.

Now that’s acting fast. That must have been partly instinct.

Denton Cooley: I think so. It’s a thing I could handle very well today, but at the time, I was not equipped by training or experience to do what I did.

After studying Dr. Christiaan Barnard’s surgical technique, Dr. Cooley completed the first successful U.S. heart transplant on May 3, 1968, giving a 47-year-old man a heart from a 15-year-old girl who had committed suicide. The patient survived for 204 days. Over the next year, Dr. Cooley performed 22 heart transplants.
After studying Dr. Christiaan Barnard’s surgical technique, Dr. Cooley completed the first successful U.S. heart transplant on May 3, 1968, giving a 47-year-old man a heart from a 15-year-old girl who had committed suicide. The patient survived for 204 days. Over the next year, Dr. Denton Cooley performed 22 heart transplants. His team went on to perform more than 118,000 open heart operations — more than any other surgical group in the world.

Can you describe the day that you did the first American heart transplant?

Denton Cooley: I was aware that Christiaan Barnard in South Africa had done two transplants, one of which was successful, and Norm Shaumway at Stanford had done one which was not successful. We were poised to do one.

We were having a difficult time finding a donor. As a matter of fact, I was over in Shreveport, Louisiana, giving a lecture to the medical society, and was telling them that we were not yet in the transplant business, and had no foreseeable opportunity to do a transplant. I got a telephone call from Houston, saying they had a donor. So I got on an airplane and came back to Houston and did the transplant that night at two o’clock in the morning, after I’d told the reporters over there that we weren’t involved in transplantation. Some of them were very upset when the news came out that we had done the first transplant.

It was an exciting thing to do. My team of doctors was here in Houston making arrangements for the donor and the operation, while I was flying back from Shreveport. After the operation, I was catapulted to a level of notoriety I had never enjoyed before.

Who was the donor?

Denton Cooley: The donor was a teenage girl with a self-inflicted gunshot wound to the head. It was a suicide attempt.

August 1968: LIFE magazine cover of Dr. Denton Cooley performing a heart transplant. In May, Cooley had transplanted a heart into Everett Thomas.
LIFE cover of Dr. Cooley performing a heart transplant. In May, he had transplanted a heart into Everett Thomas.

Could you describe the transplant procedure? How do you open somebody up and remove a heart?

Denton Cooley: First, we have to bypass the patient’s heart and get the recipient on the heart-lung machine, very much like we do for any open heart operation.

We take out the heart. Remove the heart mostly, the ventricles, and the heart valves. And then you have an open chest there, with just these various chambers exposed. We, in another operating room, will take out the heart and bring it over, and with sutures, just suture the two atria together. Those are the upper chambers of the heart. And we suture the two main arteries, the pulmonary artery, and the aorta, together. And then when you start the blood flowing back into the aorta, it gets into the coronary arteries, and that starts the donor heart, to its normal function. And that’s the whole scenario.

Physicians from all over the world have visited the Texas Heart Institute to observe Dr. Denton A. Cooley perform cutting-edge surgical procedures. This photo of a crowded Texas Heart Institute operating room was taken in 1970 as visitors observed Dr. Cooley performing a new coronary artery bypass procedure.
Physicians from all over the world have visited the Texas Heart Institute in Houston to observe Dr. Denton A. Cooley perform cutting-edge surgical procedures. This photo of a crowded Texas Heart Institute operating room was taken in 1970 as visitors observed Dr. Denton Cooley performing a new coronary artery bypass procedure.

Dr. Cooley, for all the accolades that you received for the transplants, they also raised a lot of legal and moral questions. Could you describe some of those controversies, and how you felt about them?

Denton Cooley: When cardiac transplantation was first performed by Christiaan Barnard in 1967, it’s amazing how little we knew about the true meaning of life. Where does life reside? Is it in the heart, or is it in the brain? Where is it? What is life? That’s what got everyone in such a turmoil. That’s what brought up all of these moral and ethical issues. How could a man take the heart, a beating heart, out of one individual, and put it in another? No one was concerned about the recipient. You could see why he would like to have a nice, new heart, but what about the donor? At that time, so many people were completely ignorant about brain death. This was the first time it had been pointed out clearly, and in bold print, that there was such a thing as brain death, and that once the brain had been hopelessly destroyed, these other organs, which were still functioning, could be given to someone else.

Many of the moral and ethical issues that we confronted at that time have been almost forgotten over the past couple of decades. It is interesting to me that today, even some countries that are far advanced in technology, such as Japan, still have not done a heart transplant, because certain biases exist in that society. In this particular instance, they’re not involved in what we consider educated, 20th century scientific thought. But they’ll come around to it. We have broken the ice with our work in this country, and other Western societies.

Dubbed "Dr. Wonderful" by the media, Cooley was the leading expert on congenital heart defects in children, pioneered the use of the heart-lung machine that made open heart surgery possible, co-developed a technique for repairing torn aortic aneurysms, developed the techniques of “bloodless” heart surgery, and was one of the first and most successful proponents of the coronary artery bypass graft for treating blocked blood vessels.
Dubbed “Dr. Wonderful” by the media, Dr. Denton Cooley was the leading expert on congenital heart defects in children, pioneered the use of the heart-lung machine that made open heart surgery possible, co-developed a technique for repairing torn aortic aneurysms, developed the techniques of “bloodless” heart surgery, and one of the first and most successful proponents of the coronary artery bypass graft for treating blocked blood vessels.

Have you ever had any spiritual conflicts about these tough decisions you’ve had to make? I know at times you’ve had to choose between recipients.

Denton Cooley: Yes, that is sometimes a problem. It’s a lot of responsibility deciding which individual should get the donor heart. The surgeon must also decide whether the donor organ is suitable, which is a very final decision. The only available donor heart may be of marginal quality. Should you put it into a young person, even though a transplant is the only hope for survival? It’s a heavy responsibility.

Keys to success — Courage

One of the most trying times in my career was when we did the first heart transplant. We put it into the patient, and wondered whether it was going to work. Suppose it had not functioned? We weren’t certain at all that it would function. So that five or ten minutes, while we were waiting for that heart to regain its function, was one of the most difficult times of my surgical career. And I’m sure it’s the same with other surgeons who have followed. Now we know that the heart will start up, and that’s just part of the knowledge that we have gained through the years.

Dr. Denton A. Cooley performed the first total artificial heart implant in the world, April 4, 1969, in Houston. The device, developed by Dr. Domingo Liotta, was implanted in a 47-year-old patient with severe heart failure. The patient lived for nearly three days with the artificial heart until a human heart was available for transplant. This experience demonstrated the viability of artificial hearts as a bridge to transplant in cardiac patients.
Dr. Denton A. Cooley performed the first total artificial heart implant in the world, April 4, 1969, in Houston. The device, developed by Dr. Domingo Liotta, was implanted in a 47-year-old patient with severe heart failure. The patient lived for nearly three days with the artificial heart until a human heart was available for transplant. This controversial surgery demonstrated the viability of artificial hearts as a bridge to transplant in cardiac patients.

In 1969, you engendered more controversy. What made you take the risk of implanting an artificial heart into Haskell Carr. Why was it so controversial?

Keys to success — Vision

Denton Cooley: At that time, the interest in heart transplantation was waning somewhat, because people were becoming concerned about rejection. And I knew that we were having a more difficult time getting donors. And here was a man who needed a transplant. Needed it badly and immediately, and we were having a difficult time getting a donor for him. I did know that if we used this artificial heart, we could use that as a bridge to transplantation, and it might even stimulate the actual donation of an organ. So, when the time came and things became critical with him, we went ahead and used this artificial heart to keep him alive until we could get a donor heart. And it did keep him alive. Unfortunately, he didn’t live very long after he had the heart transplantation, because he died of pneumonia. But nevertheless, it demonstrated that the artificial heart could sustain life.

In the same way, we had found a year and a half earlier that the heart transplant could sustain life.

Dr. Cooley receiving the National Medal of Technology and Innovation from President Bill Clinton in 1998.
Dr. Denton Cooley receiving the National Medal of Technology and Innovation from President Bill Clinton in 1998.

Why did people have such a big problem with this risk that you took?

Denton Cooley: Same thing as with heart transplantation. Is it justified to take that type of risk with someone, even though he was dying? Other investigators were poised to do it, but no one would do it. The same thing happened with Christiaan Barnard and the heart transplant. A lot of us were ready to do a heart transplant, but somebody had to do it first. Because we were the first to implant an artificial heart, others said it was premature, that we hadn’t done enough animal experiments. But there comes a time when you have to say, “This is a desperate situation, and we are justified in taking desperate measures.”

May 2, 1998: Cardiologist Dr. Denton Cooley in Houston, Texas. (Pam Francis/Getty Images)
May 2, 1998: Cardiologist Dr. Denton Cooley in Houston, Texas. Like many surgeons, Dr. Cooley was brimming with self-confidence and was not known for false modesty. When Cooley was a defendant in a medical liability trial, a lawyer asked Cooley if he thought of himself as the world’s best heart surgeon. “Yes,” Cooley said. “Don’t you think that’s being rather immodest?” the lawyer asked. “Perhaps,” Dr. Cooley replied. “But remember, I’m under oath.”

In the last few years, you’ve perfected the heart bypass. That went from being a tremendously risky surgery, to almost routine. How did you make such a dramatic advance in such a short time?

Denton Cooley: There’s been an evolution of techniques. We realized that you could by-pass obstructions in the coronary system. But before that, we had to find some way to substitute for the heart function. Once the heart-lung machine was developed, we had one problem solved. Then we needed a method of seeing which part of the artery was obstructed. With the development of arteriography, we had our method. With those things behind us, and with some of the experience we’d had with bypassing arterial obstructions in the legs, we learned to bypass obstructions in the coronary arteries. Today, coronary artery bypass is the most commonly performed open heart operation.