Denton Arthur Cooley, MD.

Denton Arthur Cooley, MD, a pioneering heart surgeon, died November 18, 2016, at age 96. He was born in Houston, TX, on August 22, 1920, to Ralph Clarkson Cooley and Mary Fraley Cooley. From the beginning, Cooley’s career in medicine and his contributions to humanity seem to have been foreshadowed. His father was a prominent Houston dentist, and the attending obstetrician at his birth was Dr Ernst William Bertner. Bertner would be part of the team that developed the renowned Texas Medical Center where Denton Cooley later established the now world-acclaimed Texas Heart Institute (THI). In the early 1890s, Cooley’s paternal grandfather, Daniel Denton Cooley, helped found the Houston Heights, a major suburb of the growing city of Houston. Denton A. Cooley’s pioneering career spanned the history of modern cardiovascular surgery. Beginning in the late 1940s, he developed many of today’s commonly used cardiovascular procedures and devices. Nevertheless, he is probably best known for performing the first successful human heart transplant in the United States (1968) and the world’s first human implantation of an artificial heart (1969). Many of Cooley’s other contributions, however, are equally important: the first repair of an aortic aneurysm (1949); the first repair of a ruptured abdominal aortic aneurysm (1954); the first repair of a ventricular septal defect that developed after a heart attack (1956); the first successful carotid endarterectomy (1956); new techniques for repairing diseased heart valves and congenital heart defects...the list goes on to include >30 such firsts. In some way, Cooley participated in every major development in cardiovascular surgery. With characteristic humility, he always said, “My good fortune professionally came from the fact that I began my career when heart surgery was in its infancy, when surgeons were free to discover and innovate. I’ve been a participant in so many breakthroughs primarily because I was there when they occurred. With the advent of the heart–lung machine, for example, we surgeons had the key to a door that had previously been locked. Once we had the key, then we could venture out into unexplored territory.” In the early days of open heart surgery, when few heart surgeons operated on >2 patients per day, Cooley routinely operated on 12 patients each day. He used a sugar solution rather than blood to prime the heart–lung machine, so patients were spared unnecessary exposure to blood products. More operations could be performed because less blood was needed. Cooley popularized this bloodless surgery technique, proving that open heart surgery could be done efficiently and for large numbers of patients, including Jehovah Witnesses. He felt this technique might have been his most important contribution to open heart surgery. He and his team performed over 120 000 open heart operations—more than any other surgical group in the world. Cooley’s innovations were not limited to the operating room or the laboratory. For example, he founded a managed healthcare plan that was the first to bundle cardiovascular service billing into 1 fixed fee. It saved millions of healthcare dollars and convinced others, including the Center for Medicare & Medicaid Services, to adopt this approach. Cooley believed his most important contribution to the field of cardiac care was his founding, in 1962, of THI, in the Texas Medical Center. Under his leadership, the nonprofit Institute quickly became a world leader in research, education, and patient care. It is now recognized nationally and internationally for its many significant contributions to the prevention and treatment of heart disease. Equally important to Cooley’s professional legacy is his school of surgery: the program he established at THI to train young surgeons. He was exceptionally proud to have trained so many of the next generation’s leaders in cardiac surgery. He felt through them and their trainees, his surgical legacy would always endure. He was a master at simplifying the most complex surgical procedures with a smoothness that made them look easy. Watching him operate, Dr Christiaan Denton Arthur Cooley, MD