Professor Domingo Liotta has recently published his autobiography4. I have written the following review for the book.
“MORE THAN AMAZING”
“Domingo Liotta's monumental accomplishment starting over 40 years ago to develop the first mechanical hearts used in patients is well known to most physicians and scientists.
“I have had the honor of knowing and working with him since those first days of uncertainty at the Texas Heart Institute with Dr. Denton Cooley in Houston and later in Buenos Aires. His intellectual curiosity, his capacity for work, his courage, and his dedication to patients have always been impressive. While physicians and scientists may be attracted to the new details and problems that had to be overcome with the first mechanical devices and patient care, there is much more that is truly amazing in Dr. Liotta's reminiscences. He provides new insight and never before disclosed information about the problems with the use of the first totally mechanical heart in a human patient, Haskell Karp.
“But this is only a fraction of Dr. Liotta's amazing adventures -after returning to his native Argentina he was appointed Minister of Public Health and personal physician to President Juan Perón. He was assigned the task of opening relations with the People's Republic of China and training Chinese physicians and surgeons in cardiac medicine and surgery -which he continued to do for the next 30 years. He describes monumental meetings and decisions made with then Premier Chu En-lai.
“Later he opened the Argentine government relations with the State of Israel where my cousins were Deputy Mayor of Jerusalem and Chief Rabbis of the IDF Airforce, Army, Jerusalem and Haifa.
“All of these humane and political accomplishments were made with the erudition and commitment to basic philosophies of life - beginning with ancient Western as well as ancient Chinese that make a fascinating backdrop and provide explanations for Dr. Liotta's motivation.”
Domingo Liotta, MD “Amazing Adventures of a Heart Surgeon. The Artificial Heart: The Frontier of Human Life”, iUniverse Editorial, Lincoln, NE. Impreso en Estados Unidos de América, 2007
“This is indeed an Amazing book -the world must be grateful to Dr. Liotta for recording these important human events that shaped our very existence. He has dedicated the book most appropriately, to his patients”.
Contribution, impact and importance of the work developed by Domingo Liotta
“Professor Domingo Liotta, MD is a surgeon who invented mechanical devices called artificial hearts or Left Ventricular Assist Systems (LVASs) to treat patients with Advanced Heart Failure.
“He implanted these devices to improve and prolong life thereby demonstrating the immense medical, humanitarian, social and economic value of such devices. His achievements and methods have had a sustained global impact. He developed these systems while Professor of Surgery at Baylor University College of Medicine, Houston, Texas.
“For the first time in medical history, the following artificial heart systems were implanted into patients:
- Liotta-Crawford, Intrathoracic LVAS (July 19, 1963);
- Liotta-DeBakey, Paracorporeal LVAS (April 21, 1966);
- Liotta-Cooley, Total Artificial Heart (April 4, 1969).
“The implantation of LVASs is now a well-established clinical procedure as a bridge for Cardiac Transplantation and as a bridge for Myocardial Recovery. In the USA alone 5 million patients are in NYHA-class IV (severe) heart failure; 400,000 of them die yearly and 400,000 more are newly diagnosed. Health care costs $28 billion per annum, a medical-social catastrophe.
“Dr. Liotta has shown a way for combination therapies as a future in the 21st Century to optimize cardiac function in heart failure. In 1998, he began testing a new, smaller LVAD system, the ‘Novel’ with left atriostomy drainage so that the inflow blood path avoids damage to the cardiac pumping chamber, the left ventricle.
“Dr. Liotta also wrote the Public Health Law for Argentina which he presented to the United Nations; it has been used as a basis similar health law by other countries.
“As Minister of Health for Argentina he visited China and Israel to open scientific and cultural relations with Argentina and personally trained Chinese physicians for 23 years”.
A detailed description of Domingo Liotta´s work, and its projected influence in the relevant field
“Domingo Liotta is the inventor of the first artificial mechanical hearts implanted into human patients -both left ventricular assist systems, LVASs and total heart replacements. His dedication to develop these devices is described in his recently published autobiography.
“For the past four decades, his moral tenacity and perseverance have been remarkable. He has cared for and assisted extremely ill cardiac patients. To face this heavy burden plus his overloaded research he has always encouraged himself under the old maxim, “Heaven kindly gave our blood a moral flow.”
“In the 1960s, while working at the Experimental Laboratory in Baylor University College of Medicine in Houston, Texas he demonstrated that the damaged heart was able to improve contractile performance (Functional Heart Recovery) when the size and shape of the left ventricular chamber that occurs with heart failure was relieved of some of its work (blood unloading).
“He noted that Cardiac Recovery after LVAS implantation —with ventricular blood unloading— occurs primarily by attenuation of myocyte stretch-induced responses. Dr. Liotta showed the importance of mechanical restoration of intracardiac Pressure-Volume relationship and circulatory systemic flow to more normal levels, as they were decisive in the treatment of patients in cardiogenic shock postcardiotomy.
“In 1966, surgeons DeBakey and Liotta implanted an artificial left ventricle in a paracorporeal position -the Liotta-DeBakey paracorporeal LVAS. The patient underwent a double valve replacement but could not be weaned from extracorporeal circulation. Then, an LVAS, which supported the circulation for ten days at a rate of 1,200 mL/min, was implanted. The patient recovered, making this the first successful use of an LVAS for postcardiotomy shock.
“The importance of this work and its influence had immediate worldwide impact that continues to this day and will continue into the future to benefit many generations.
“Liotta’s pioneering works at Baylor University and at the Texas Heart Institute have been progressively confirmed in myocardial histology after LVASs followed by Heart Transplantation. Human failing heart studies of anatomy, histopathology, and mitochondrial function confirmed Liotta’s early pathophysiological observations.
“On April 4, 1969 Denton A. Cooley and Domingo Liotta replaced a dying man’s heart with a Total Orthotopic (inside the pericardial sac) Mechanical Heart following the removal of the badly diseased natural heart. This artificial heart kept the patient alive for 64 hours before he received a heart transplant.
“Thirty-nine years have passed since this historic operation and mechanical hearts and LVADs are now an accepted and valuable part of the practice of medicine.
“On December 5th 2006, Denton A. Cooley, President and Surgeon-in-Chief of the Texas Heart Institute wrote to Dr. Liotta, “The Liotta-Cooley artificial heart was selected to be displayed prominently in the new Smithsonian Treasures of American History establishing it as a worthy contribution to human history.”
“In 1998 Liotta started working on a new and advanced LVAS, the Novel-LVASs that uses a drainage technique that avoids additional damage to the patients already damaged heart and preserves the normal helical heart contractions.
“Dr. Liotta has also utilized his medical knowledge and humanitarian dedication as the author of the Public Health Law of Argentina that he presented at the United Nations.
“As an Ambassador for Argentina he opened scientific and cultural relations with China and Israel and personally trained Chinese physicians for 23 years (1973-1996).
“His contributions to social welfare and medical care cannot be exaggerated; they are ‘a testament to the moral values of man’.