Few innovations in surgery carry the same mix of promise and controversy as the total artificial heart. Later this afternoon, William E. Cohn, MD, FACS, from The Texas Heart Institute and Baylor College of Medicine in Houston, Texas, will deliver the I. S. Ravdin Lecture in the Basic and Surgical Sciences, “The Past, Present, and Future of the Total Artificial Heart: A Very Houston-Centric Story.” In his lecture, he promises to explore not only the history of artificial heart innovation but also the paradigm-shifting work that may finally bring a permanent solution for end-stage heart failure.
The lecture will be from 4:15 to 5:15 pm in Room W-176.
For Dr. Cohn, this moment has been decades in the making. His ties to the history of mechanical circulatory support run deep. He trained under Michael E. DeBakey, MD, FACS, and later joined the group led by Denton A. Cooley, MD, FACS—two titans of cardiovascular surgery whose professional rivalry shaped Houston’s role as the epicenter of heart surgery innovation. In many ways, Dr. Cohn has inherited that mantle, working alongside his longtime mentor O. H. “Bud” Frazier, MD, FACS, and now collaborating with biomedical engineer Daniel Timms, PhD, to pursue a device that challenges conventional thinking about how blood can be pumped.
History Rooted in Houston
Dr. Cohn’s lecture will begin with the early history of total artificial heart research, much of which was focused in Houston in the 1960s. Attendees can expect vivid storytelling about the remarkable events surrounding the first clinical implant of an artificial heart in 1969, performed by Dr. Cooley while Dr. DeBakey was in Washington, DC. That case—briefly successful but ultimately tragic—ignited decades of controversy and innovation, leaving an indelible mark on the field.
Dr. Cohn grew up in Houston during this era, reading about these breakthroughs in the newspaper as a young boy. He recalled taking an article on the first artificial heart to school and nervously explaining it to his classmates when his teacher asked him to share. “At 8 years old, I emerged as the subject matter expert in my peer group,” he joked. That moment of childhood awe foreshadowed a lifelong dedication to cardiac innovation.
Rethinking the Beating Heart
Every artificial heart built over the last 70 years has attempted to mimic the native organ’s pulsatility. But therein lies the problem, explained Dr. Cohn: the human heart beats approximately 100,000 times per day, 35 million times per year. No manmade device with moving parts can withstand that level of mechanical stress indefinitely. For this reason, total artificial hearts have served only as bridges to transplant—not permanent solutions.
As Dr. Cohn will explain in the lecture, he and his team have taken a radically different approach. Rather than duplicating nature’s design, they have embraced continuous-flow technology—already proven in ventricular assist devices—and extended it to a total artificial heart. The result is a small titanium device with a single moving part (rotor), suspended in a magnetic field, spinning silently to pump blood into the body and lungs without valves, membranes, or wear points.
“It’s like science fiction,” Dr. Cohn said. “There’s no mechanical wear. The rotor never touches anything. There’s no reason it shouldn’t last indefinitely.” Early animal studies and first-in-human implants have been promising, and the device has already supported patients at home under FDA approval protocols.
From Humble Beginnings to Global Collaboration
The lecture also will spotlight the grassroots innovation that fueled this breakthrough. Dr. Cohn described how early prototypes were 3D-printed in plastic, tested in animal labs, and refined in a small workshop. What began with a handful of engineers has grown into an international effort, with cases now performed in the US and Australia, and in the near future, Hong Kong and Taiwan.
At the center of this story is Dr. Timms. His father’s death from heart failure inspired him to devote his life’s work to developing an artificial heart. Dr. Timms’s vision and persistence brought him to Houston, where he partnered with Drs. Cohn and Frazier to advance the project.
“Big projects have humble beginnings,” Dr. Cohn reflected. “And when you meet somebody brilliant who is working on something that excites you, don’t let them leave your side.”
Challenges Ahead
Despite the optimism, Dr. Cohn acknowledged the hurdles that remain, and he plans to share details in his presentation. Eliminating external drive lines to create a fully implantable, sealed system is one priority. Long-term durability and safety data are still being collected, and unforeseen complications may emerge. According to Dr. Cohn, if the device continues to perform as early results suggest, it could transform the treatment of end-stage heart failure, a condition that kills more than 150,000 Americans annually.
This technology also has significant potential to revolutionize the field of heart transplantation. Currently, only 4,500 or so patients per year receive donor heart transplants in the US. The gap between need and availability is staggering. A shelf-ready, permanent artificial heart could fill that void and become “one of the most dramatic advances in modern medicine,” said Dr. Cohn.
Attendees, though, can expect more than a technical discussion. Dr. Cohn plans to weave in personal stories of mentorship, rivalry, and serendipitous collaboration. He will share photos of his mentors, his own global teaching experiences, and even glimpses of life outside the OR, where he moonlights as a magician and musician.
In addition, Dr. Cohn expects the lecture to carry broader lessons as well: “This is not a dress rehearsal. Be bold with your ambition and do really cool stuff. This has brought incredible meaning to me professionally, and everybody who will be in that room has potential to craft journeys like this. And if you like innovation, understanding that there's a well-worn path might help lower the perceived obstacles for would-be innovators to start their own adventure.”
The I. S. Ravdin Lecture series, named after the distinguished surgeon Isidor Schwaner Ravdin, MD, FACS, features prominent surgeons and medical scientists highlighting breakthroughs and future directions in basic science and surgical practice. Dr. Ravdin was a fourth-generation physician who combined research with surgery and completely changed the fields of both. During his 40+ years at the Hospital of the University of Pennsylvania in Philadelphia, Dr. Ravdin rose to become chief of surgery and director of research.
