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Adrian Kantrowitz Papers

 Collection
Identifier: MS C 572

Abstract

Adrian Kantrowitz was an American heart surgeon and medical investigator responsible for pioneering developments in circulatory assist devices, artificial organs, medical electronics, heart transplantation, and research motion pictures. Grant material, experiment data, patient medical records, correspondence, publications, conference material, publicity clippings, and audio-visual media document Adrian Kantrowitz's professional career in cardiovascular research at the Maimonides Hospital in Brooklyn and the Sinai Hospital of Detroit.

Dates

  • 1944-2004

Extent

64 Linear Feet (44 boxes + films)

Creator

Physical Location

Materials stored onsite. History of Medicine Division. National Library of Medicine

Language of Materials

Collection materials primarily in English

Access Restrictions

Collection is restricted. Portions of the collection are restricted according to HMD's Access to Health Information of Individuals policy. Contact the Reference Staff for information regarding access. For access to the policy and application form, please visit https://www.nlm.nih.gov/hmd/pdf/Personal-Health-Information-Policy.pdf.

Copyright and Re-use Information

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Privacy Information

Archives and manuscript collections may contain materials with sensitive or confidential information that is protected under federal or state right to privacy laws and regulations. Researchers are advised that the disclosure of certain information pertaining to identifiable living individuals represented in any collection without the consent of those individuals may have legal ramifications for which the National Library of Medicine assumes no responsibility.

Biographical Note

U.S. heart surgeon and medical investigator Adrian Kantrowitz was born on October 4, 1918 in New York City, to general practitioner Bernard Abraham and his wife Rose. Adrian Kantrowitz was responsible for pioneering developments in circulatory assist devices, artificial organs, medical electronics, heart transplantation, and research motion pictures.

His interest in medical research began as a child through kitchen experiments conducted with his older brother Arthur, who eventually became a physicist and cofounder of Avco Research Laboratories. Adrian received his bachelor's degree in mathematics from New York University in 1940 before attending the Long Island College of Medicine, now known as the State University of New York (SUNY) Downstate Medical School. Due to the growing need for doctors during World War II, he underwent an accelerated program and was awarded his medical degree in 1943.

A nine month internship at the Jewish Hospital of Brooklyn fostered Kantrowitz's initial career interest in neurosurgery. While there, he proposed a new type of clamp for performing craniotomies during intracranial surgery that became the subject of his first published paper, "A Method of Holding Galea Hemostats in Craniotomies," in 1944. World War II halted Kantrowitz's research work for two years while he served as a battalion surgeon in the U.S. Army Medical Corps. After being discharged in 1946 with the rank of major, Kantrowitz switched his specialty to general surgery because of the lack of available training positions in neurosurgery. He was intensely interested in the possibility of surgical procedures to help the failing heart, but at that time there were no training programs in cardiac surgery. He would spend the rest of his career devoted to cardiovascular research, typically working eighteen-hour days six days a week.

From 1948 to 1955, Kantrowitz held various positions at the Montefiore Hospital in the Bronx. Through his experimental work with animals, Kantrowitz began developing an artificial left heart (a device he would continue refining for many years), an early automated pump oxygenator for open heart surgery, and a treatment for coronary artery disease that involved surgically rearranging blood vessels. This practice of testing experimental surgeries on animals (particularly dogs) before human beings continued throughout his career. In 1954 with the help of Alan Lerrick, a colleague at Montefiore Hospital's Surgical Research Laboratory, he invented a plastic heart valve that served as an extra heart pumping blood into anemic organs. During his time at Montefiore, Kantrowitz entered a one-year fellowship under distinguished cardiovascular physiologist Carl Wiggers at the Western Reserve University School of Medicine in Cleveland.

During this time at Montefiore Hospital, Kantrowitz filmed the first of many pioneering research motion pictures. His film offered a color close-up look inside a living dog's heart while the organ was still inside its chest. The artificial heart designed by Kantrowitz to keep the dog's heart free of blood while supplying blood to the rest of the body also provided a clear view of the living organ in action. On October 16, 1951, he screened the world's first motion picture of the inside of a living heart before 350 physicians at the annual Graduate Fortnight of the New York Academy of Medicine.

Kantrowitz began a fifteen-year professorship at SUNY Downstate Medical Center in 1955 and established a lasting friendship with Chief of Surgery Clarence Dennis. That same year, Kantrowitz received an appointment to the full-time position of Director of Cardiovascular Surgery at the Maimonides Hospital (later known as Maimonides Medical Center), a 600 bed community hospital in Brooklyn. For the next fifteen years, Kantrowitz held a variety of positions at Maimonides and led a research team that devised a series of innovative electronic devices to compensate for various physiological malfunctions. These devices included the extremely sensitive, electronically controlled heart-lung machine (developed in 1958) that allowed him to execute a series of successful open heart surgeries in children. Kantrowitz also created a diaphragm booster heart with William M. P. McKinnon that functioned as a second heart, relieving the natural heart of 25% of its work. In 1960, Kantrowitz and Rene Khafif built a large electronic system to deliver electric shocks to anesthetized dog legs and produce walking motions, an important advancement in paralysis treatment. He programmed stimulation of limb muscle movements of a 25 year old paraplegic, enabling him to stand up and sit down under computer control. This was the first demonstration of the feasibility of programming walking movement in patients with paralyzed legs. A mini radio transmitter emitting signals that caused paralyzed human bladders to empty was also developed around this time. Kantrowitz also collaborated with the Electronics Laboratory at General Electric to successfully design and manufacture an external radio controlled, internal cardiac pacemaker to implant in human patients suffering from heart ailments such as Stokes-Adams disease.

Building upon past artificial left heart and booster heart experiments, Kantrowitz and collaborators such as his brother Arthur, Tetsuzo Akutsu, Franz Gradel, and Paul-Andre Chaptal worked throughout the 1960s on a mechanical auxiliary left ventricle to aid the failing heart. Their goal was to create an externally controlled, valveless, internal pump synchronized with the body's regular pumping cycle through the natural heart's electrical activity. It was implanted in the ascending aorta, leaving the native heart intact. After numerous dog tests, Kantrowitz carried out the world's second permanent partial mechanical heart implantation in a human on February 4, 1966. Although the auxiliary ventricle worked, the patient died after twenty-four hours from advanced liver disease. Kantrowitz's second highly publicized attempt at implanting a partial mechanical heart in 63-year-old Louise Ceraso on May 18, 1966, also ended in disappointment when she died of a stroke thirteen days later. At the same time, Kantrowitz was encouraged by the performance of the device. It took Mrs. Ceraso out of heart failure. When the device was turned off, she went back into heart failure, and when pumping was resumed, she was again taken out of heart failure. This cycle was repeated many times, confirming that such an assist device could become a treatment for heart failure. Kantrowitz later expressed the opinion that the difficulties faced by contemporary Michael E. DeBakey and himself suggested that effective mechanical heart implantation was still many years away.

The intra-aortic balloon pump created by Kantrowitz's team during this period proved to be a more successful heart assist device. Devised as a quick, non-surgical form of temporary mechanical heart assistance, the balloon pump facilitated increasing blood flow and oxygen to the heart muscle until the ventricle could resume pumping on its own, A trial run on a female patient in 1967 enabled her to recover from cardiogenic shock, almost always fatal at that time. Kantrowitz subsequently used the balloon pump to treat patients suffering from myocardial infarction and organized a cooperative study of 9 medical centers which confirmed his results.

Kantrowitz was a major contender in the race to perform the world's first total human heart transplant. His team transplanted hearts in 411 dogs over a five year period in preparation for human trials. The surgery required a suitable donor and recipient at the same time, which occurred in 1966. The procedure was cancelled because the condition of the donor heart was too poor. On December 6, 1967, three days after Christiaan Barnard's historic surgery in South Africa, Adrian Kantrowitz completed the United States' first and the world's second human heart transplant. A 2.5-week-old male infant suffering from severe tricuspid atresia received the heart of a two-day-old male infant dying of anencephalitis. The surgery was the first performed on an infant and lasted 2.5 hours; the recipient lived only 6.5 hours. After the death of his second patient (an adult) in January 1968, Kantrowitz renewed his efforts in mechanical methods of assisting the failing heart. He believed the key to success in heart transplantation lay in overcoming rejection, and that his community hospital could not develop the needed expertise in immunosupression. At the same time, the early deaths of recipients throughout the world were met with growing public criticism against cardiac transplants.

Ethical questions about the scope of Kantrowitz's research, in particular, whether the intraaortic balloon pump was really effective, escalated existing tension with the administration at Maimonides Hospital. In 1970, Kantrowitz relocated his entire team of surgeons, researchers, biomedical engineers, and nurses to Sinai Hospital of Detroit, Michigan, where he was now an attending surgeon and Chairman of the Department of Surgery. He held several positions at Sinai Hospital over the next three decades and also served as Professor of Surgery at the Wayne State University School of Medicine until his death, November 14, 2008. In this new work environment, Kantrowitz continued experimenting with heart transplants, the balloon pump, and partial mechanical hearts. In August 1971, he implanted an artificial heart booster (a more advanced version of the auxiliary left ventricle) into 63-year-old Haskell Shanks, who became the first partial mechanical heart patient to be sent home. He died three months after the surgery because of infection at the site where the tube to the drive unit exited through the skin. A second patient also was improved hemodynamically by the "dynamic aortic patch" as it was then called, but also died for the same reason. Dr. Kantrowitz suspended further work on the heart assist system to develop a skin access device that would remain stable and resist infection. For the next 20 years he collaborated with researchers at the University of Michigan to develop a percutaneous access device precoated with cells derived from the recipient's skin. This approach was successful and he resumed investigation of his improved left ventricular system, now called the CardioPlus, using it to treat patients in advanced heart failure.

Adrian Kantrowitz married Jean Rosensaft on November 25, 1948; she worked on the administrative staff of the surgical research laboratories at Maimonides Medical Center during his tenure there. In 1983, Dr. Kantrowitz, Mrs. Kantrowitz, and Paul Freed, a long-time bioengineering colleague, cofounded L.VAD Technology, Inc., a Detroit-based research and development company specializing in cardiovascular devices. Dr. Kantrowitz died on November 14, 2008, survived by his wife, Jean, two daughters, Niki Ellen and Lisa Robin, and a son, Allen Bernard.

Brief Chronology

1918
Born October 4 in New York City to Bernard Abraham and Rose Kantrowitz
1940
Receives bachelor's degree in mathematics from New York University
1943
Receives medical degree from Long Island College of Medicine
1944
Completes nine-month internship at Jewish Hospital of Brooklyn, New York; publishes first paper
1944-1946
Serves in the U.A. Army Medical Corps as a battalion surgeon; discharged as a major
1947
Assistant Resident in Surgery at Mt. Sinai Hospital in New York
1948
Marries Jean Rosensaft November 25
1948-1950
Assistant Resident in Surgery and Pathology, then Cardiovascular Research Fellow then Chief Resident in Surgery at Montefiore Hospital in New York
1951-1952
USPHS Fellow in Cardiovascular Research in the Department of Physiology at Western Reserve University School of Medicine in Cleveland
1951-1955
Adjunct Surgeon at Montefiore Hospital
1955-1964
Director of Cardiovascular Surgery and Director of Surgical Research at Maimonides Hospital (later Maimonides Medical Center) in New York
1955-1970
Attending Surgeon at Maimonides Hospital
1955-1970
Assistant Professor, then Associate Professor, then Professor of Surgery at State University of New York (SUNY) College of Medicine
1964-1970
Director of Surgery at Maimonides Hospital
1970-
Clinical Professor of Surgery at Wayne State University School of Medicine in Detroit, Michigan
1970-
Attending Surgeon in Cardiovascular/Thoracic Surgery at Sinai Hospital of Detroit, Michigan
1970-1975
Chairman of the Department of Surgery at Sinai Hospital of Detroit
1975-1983
Chairman of the Department of Cardiovascular Surgery at Sinai Hospital of Detroit
1978-1993
Director of Surgical Research at Sinai Hospital of Detroit
1983-2008
Co-founder and President of L.VAD Technology, Inc.
2008
Died November 14, age 90, from complications of heart failure

Selected Awards

1949
Henry L. Moses Research Prize
1952
First Prize, Scientific Exhibit, New York State Medical Society
1966
Gold Plate Award, American Academy of Achievement
1966
Max Berg Award for Outstanding Achievement in prolonging human life
1967
Theodore and Susan B. Cummings Humanitarian Award, American College of Cardiology
1967
Israel Freedom Medal
1972
President's Cabinet Award, University of Detroit
1985
Ninth Hastings Lecture, National Institutes of Health, NHLBI
1993
ASAIO Teacher's Award
1993
Dr. Barney Clark Award
1999
AMMI Foundation Laufman-Greatbach Prize
2001
ASAIO Lifetime Achievement Award

Collection Summary

Grant material, experiment data, patient medical records, correspondence, publications, conference material, publicity clippings, and audio-visual media (64 linear feet; 1944-2004) document Adrian Kantrowitz's professional career as a cardiovascular surgeon and investigator. Languages include French, Spanish, German, Italian, Japanese, Dutch, Russian, Jewish, Slovak, and Serbo-Croatian.

Kantrowitz devoted his research to devising surgical procedures and mechanical assist devices to correct numerous physiological ailments, with a particular focus on aiding or replacing the failing heart. Six research project series (Series 2-7) document the surgical research conducted and mechanical devices developed by Kantrowitz and his colleagues at the Maimonides Hospital in Brooklyn and the Sinai Hospital of Detroit. They contain raw data and patient files from animal and human experiments, along with administrative records, correspondence, publications, and other material related to the development and promotion of their research. Records cover the following projects: Artificial Left Heart, Electronic Physiologic Aids, Mechanical Auxiliary Ventricle, Intra-Aortic Balloon Pump, Heart Transplant, and Other Research Projects. The largest group of records is devoted to Kantrowitz's attempts at heart transplantation, with special attention given to the first human heart transplant performed on an infant in 1967. Information on the ongoing progress of Kantrowitz's research projects can also be found in the reports and invention statements in Series 1: Grants and Funding, which documents the grants and foundations that financed his research.

Many of the films that made Kantrowitz a pioneer in research motion pictures are located in Series 9: Clinical Films. Included are recordings of the experimental dog and human surgeries that furthered his experience in areas such as cardiovascular surgery, electronic physiologic aids, and heart transplants.

Copies of reprints, reports, and other published works from throughout his career are in Series 10: Writings. These articles highlight the ongoing development of Kantrowitz's mechanical devices as well as his circulatory, bladder stimulation, and surgical research. Articles covering Kantrowitz, his colleagues, his competitors, and the medical world at large are located in Series 8: Publicity.

Kantrowitz's professional activities are documented in Series 11: Presentations and Talks; Series 12: Conferences, Meetings, and Events; and Series 13: ASAIO. Series 11 focuses on speeches presented by Kantrowitz and others in his field. Series 12 covers a wide range of regional, national, and international events devoted to topics from cardiovascular and thoracic surgery to medical and biomedical engineering. Series 13 provides information on Kantrowitz's activities as a member of the American Society for Artificial Internal Organs (ASAIO)

Abstract

Adrian Kantrowitz was an American heart surgeon and medical investigator responsible for pioneering developments in circulatory assist devices, artificial organs, medical electronics, heart transplantation, and research motion pictures. Grant material, experiment data, patient medical records, correspondence, publications, conference material, publicity clippings, and audio-visual media document Adrian Kantrowitz's professional career in cardiovascular research at the Maimonides Hospital in Brooklyn and the Sinai Hospital of Detroit.

Physical Location

Materials stored onsite. History of Medicine Division. National Library of Medicine

Provenance

Gift of Adrian and Jean Kantrowitz, 2002-2007. Accession #2002-092, etc.

General

Processed by
Erica Haakensen
Processing Completed
March 2008
Encoded by
Erica Haakensen
Title
Finding Aid to the Adrian Kantrowitz Papers, 1944-2004
Status
Unverified Partial Draft
Author
Erica Haakensen
Date
March 2008
Language of description
English
Script of description
Latn
Language of description note
Finding aid is written in English
Edition statement
1.0

Collecting Area Details

Part of the Archives and Modern Manuscripts Collection Collecting Area

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