MEDICAL MATTERS:A look at the life of Michael DeBakey, the unasssuming inventor of the artificial heart graft, who died last month, Dr Muiris Houston
THE ATMOSPHERE in the operating theatre was tense. There was blood everywhere. All of us present, from the lowly intern (me), to the experienced theatre sister and the professor of surgery, held our collective breaths.
We stared into the abdomen of the 68-year-old man who hours earlier had come to the hospital with the first signs and symptoms of a leaking aortic aneurysm. The aorta is the large vessel that carries blood from the heart to the abdomen and the legs; it can sometimes balloon outwards at a certain point to create what is called an aneurysm.
Above a certain size, aneurysms become troublesome: if the victim is lucky, they go off slowly in the form of a leak; but aneurysms may also rupture and bleed suddenly, causing the person to die.
Our patient was lucky: after hours of painstaking surgery we had got him to the point where a patch had been applied to the damaged part of the blood vessel. We were now looking intently to see if the patch would hold, or whether blood would leak slowly from its stitched edge.
The patch in question was a Dacron artificial graft, which has transformed the practice of vascular surgery. It meant that previously inoperable aneurysms of the aorta could now be surgically repaired.
The inventor of the Dacron patch died last month. Michael Ellis DeBakey was a true pioneer of cardiovascular surgery. In 1952, he successfully repaired an aortic aneurysm by replacing the damaged segment with a graft from a cadaver.
But DeBakey was concerned that natural grafts would themselves contain atherosclerosis and could lead to further problems for the patient. He reputedly worked at home with his wife's sewing machine developing the artificial graft. A year later, in 1953, he performed the first successful aneurysm repair using Dacron.
The professor I worked with as a surgical intern had trained with DeBakey, and spoke regularly of the man's brilliance. But it wasn't until I read his obituary in a number of medical journals that I realised just how influential he had been.
Born in Louisiana in 1908, DeBakey was the oldest child of Lebanese Christian parents (Da Baghi) who left the Middle East because of religious intolerance. A medical graduate of Tulane University in New Orleans, he completed his studies at the University of Strasbourg, France and Heidelberg University in Germany. He spent the rest of his career at Baylor College of Medicine and Methodist Hospital, Houston, Texas.
Fans of the long-running TV series MASH can thank DeBakey: during the second World War he developed the Mobile Army Surgical Hospital (MASH) concept. It was an inspired move that brought battlefield surgery close to the front line. And, of course, Hollywood illustrated its further development in the Korean and Vietnam wars to great effect.
DeBakey pioneered coronary artery bypass surgery. In a 2005 lecture to the New York Academy of Medicine, he recalled that his team at Houston had performed the first successful coronary bypass operation in 1964, but did not announce the breakthrough for 10 years.
He was also the first surgeon to carry out a carotid endarterectomy, in which blockages in the neck vessels that supply the brain are removed. This operation went on to become the standard surgical procedure for people considered to be at high risk of stroke.
DeBakey also showed his talents as an inventor when he develped a ventricular assist device (VAD). Anticipating a shortage of hearts for transplantation, the device helped keep people alive until a suitable organ became available. Modern versions are now used to treat patients with severe heart failure.
Having carried out more than 60,000 cardiovascular procedures, it is not suprising to learn that DeBakey continued to operate into his 90s. And, in an interesting twist, at the age of 97 he himself underwent an operation where his colleagues replaced part of his aorta with an artificial graft.
DeBakey attributed his longevity to never having smoked and to good genes that enabled other members of his family also to live into their 90s.
For those less fortunate than he was, this remarkable medic has directly and indirectly helped save thousands of lives. Among the many whom DeBakey has helped was our patient who went home, fit and well, to his wife and family some two weeks after coming off the operating table.
...
Dr Houston is pleased to hear from readers at mhouston@irish-times.ie but regrets he is unable to reply to individual medical queries