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Pittsburgh cardiac surgeon, inventor honored for life's work

Dr. George Magovern Sr.'s life has been ruled by two passions: healing and inventing

Tuesday, February 11, 2003

By Mackenzie Carpenter, Post-Gazette Staff Writer

George Magovern Sr. made his name fixing hearts at Allegheny General Hospital, but his life story reads as much like an inventor's as it does a heart surgeon's.

The Magovern men, from left, James, George Sr., and George Jr. The senior Magovern is being honored by the American Heart Association for a lifetime of work. (Denis Poroy)

So when a reporter called recently to discuss his upcoming award from the American Heart Association, Magovern, a plain-spoken man with an easy chuckle, seemed more eager to discuss what he's working on now then dwelling on past triumphs -- specifically, his consulting work for a new "tandem" heart device, still in the testing stage, that takes over pumping chores of a damaged heart.

It's just one more in a long line of revolutionary devices that have saved thousands of lives.

There is, of course, the valve Magovern perfected nearly 40 years ago that helped change the direction of heart valve surgery.

There were other innovations, too: heart assist pumps that dramatically improved survival rates for patients with congestive heart failure; nuclear-powered pacemakers that lasted longer than battery powered ones; and life-saving breathing tubes he developed with Respironics founder Gerald McGinnis.

He also came up with what seemed a radical idea at the time: wrapping a damaged heart in the patient's own back muscle, and using a special pacemaker to teach the muscle to pump.

"He's a very practical man," says Dr. James Burkholder, his longtime partner who retired recently as a senior cardiac surgeon at Allegheny General. "He tries to foresee what will be important and then he goes to work. He's not a theoretician. He spent his time trying to solve clinical problems."

Magovern, 78, of Fox Chapel, did it all for a simple reason: he couldn't bear to see people dying.

"You have to invent things, because what was happening was terrible. People were dying, and it was hard to stand there and not do something."

Over the years, Magovern has won much recognition -- his proudest moment, he says, was being named president of the Society of Thoracic Surgeons, the largest group of cardiac surgeons in the world -- and he's still getting it. On Saturday, he will be honored with the "Pulse of Pittsburgh Award" by the American Heart Association in recognition of his achievements and leadership in battling heart disease. The award will be presented at the association's Heart Ball.

"He's an icon," says Marjorie Thomas, division director for the heart association. "He put us on the map for heart surgery. He's just a superb human being in addition to being a superb physician and surgeon. And he not only gives to the medical community but to Pittsburgh community,"

Childhood dream

Magovern never wanted to be a heart surgeon when he was growing up. That's because there weren't any. Heart surgery, with its dashing, cowboy-esque heroes -- Denton Cooley, Michael DeBakey, Christian Barnaard -- emerged after World War II. Still, Magovern, who was born and reared in Brooklyn, N.Y., always wanted to be a doctor. While his father was in the insurance business, his uncle was a doctor and his older brother would become one.

 
 

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"They were respected, at least in my family. They always seemed to be doing good."

Magovern lived a typical American childhood: he rooted for the Dodgers at Ebbets Field in New York and met his future wife, Ann, at a high school dance. World War II broke out just as he was accepted into medical school. He had joined the Navy, which sent him to Marquette University/Medical College of Wisconsin.

Weeks after he retired his naval commission, the Korean War broke out. He joined the Army and was stationed at Fort Sam Houston in San Antonio, Texas, where his interest in cardiac surgery began to grow.

Because of World War II, and advances in anesthesia, antibiotics and blood transfusions, doctors were operating on heart wounds, something rarely done before. The techniques were horrendously primitive by today's standards: a surgeon would cut a small incision in a heart, insert his finger and use it to unclog a narrowed valve.

After the war, Magovern moved on to George Washington University Hospital in Washington, D.C., to work with Dr. Brian Blades, best known as President Eisenhower's surgeon. By the 1950s, heart disease had become the No. 1 killer in the country. And if the 1960s were to be the decade of the heart-surgeon-as-celebrity (Christian Barnaard, after all, dated Sophia Loren) the 1950s were when key advances laid the groundwork.

The first open heart surgery was performed successfully at the University of Minnesota in 1952, and then, heart-lung machines were developed allowing surgeons more time to operate. Then it was on to bypass surgery, heart transplants, artificial hearts and other breakthroughs.

As part of George Washington's program, Magovern was sent to Pittsburgh in 1959 to work at Allegheny General with Dr. Edward Kent, the hospital's first director of cardiothoracic surgery. He was to stay only six months, but that turned into a lifetime, and it wasn't long afterward that he began making history.

The Magovern valve

The aortic valve is a little triangular structure that serves as a door to the heart, opening and shutting as the blood flows through. It's a complex mechanism that, over 50 years, "opens and closes 2 billion times," says Magovern's son James. It's prone to all kinds of problems that are still not well understood.

George Magovern Sr.'s improvement of the ball-in-a-cage heart valve feature tiny "teeth" that allowed surgeons to clamp it into place, rather than taking precious time to sew it in. (Darrell Sapp, Post-Gazette)

But in 1961, with the advent of a new artificial valve known as the ball-in-a-cage model, surgeons were hopeful of success in treating these problems. The device featured a silicone rubber ball held loosely in place in a "cage" of three curved metal fingers. When the heart pumped, the ball pushed away from the valve's opening, allowing blood to pass, before moving back against the opening to seal it shut.

Still, it took an hour or more to sew these devices into the heart, which raised the risk of irreparable heart damage. Dismayed by the high number of patients dying, Magovern started visiting local machine shops to look for help in making a device that would save valuable minutes in the operating room.

At one place, a man named Harry Cromie overheard Magovern's inquiry and followed him into the parking lot, offering his services. Cromie had taken a few engineering classes and had a workshop, so the two men spent the next few months in Cromie's Mt. Lebanon basement, perfecting a model that would clamp into place with little teeth.

"It was unique in that it had a claw-like fixation device that did not require sewing, which was critical when time was of the essence," Burkholder says.

Those experiments led to Magovern performing the state's first heart-valve replacement in 1961, and throughout the next decade, thousands of people had heart valve surgery using devices based on his idea. Many of these patients are still alive and well today.

"I used his valve, although I made some of my own alterations to it," says legendary heart surgeon Dr. Denton Cooley, 82, in a telephone interview from Texas "He and I go way back ... We were both young surgeons trying to explore and make contributions to the emerging field in heart surgery, and I participated in some of the surgical procedures with him in Pittsburgh. He is one of the real pioneers."

There were other achievements. Magovern performed the city's first coronary artery bypass for coronary obstruction, the world's second lung transplant and was the second in the state to perform a heart transplant in 1969.

During this time, he also helped encourage and invested financially in local start-up companies developing new medical technology. After the valve's success, Magovern and Cromie founded Surgitool Corp., which became the leading U.S. company for heart-valve design. Magovern also helped to launch a medical respiratory device company with engineer McGinnis that later became Respironics. His work on a nuclear-powered pacemaker led to the creation of another company, Coratomic Pacemaker Inc.

"There aren't an awful lot of doctors who commit personal funds the way he has done. He invested a tremendous amount of seed money," Burkholder says. "He always felt that if he was going to be an innovator, he needed to put his money where his mouth was and support these people."

A spirit passed on

That generosity of spirit was felt by his two sons, George Jr. and James, who found it easy to follow his footsteps, something not all children of famous fathers do.

Today, they work together at Allegheny General -- George, 50, heads the hospital's Division of Cardiovascular Surgery; brother James, 48, oversees its cardiovascular research program.

Heart surgery today is a field substantially different from what it was in their father's younger days. The jaw-dropping breakthroughs -- transplants, artificial hearts -- are in the past. While bypass surgery is still common, "it's not a growth industry" James says, mainly because of advances in prevention and the increased use of stent implantation by cardiologists.

All the breakthroughs and advances, according to cardiology experts quoted in a recent New York Times article, have made heart disease today less about crises and more about managing a chronic disease.

But James Magovern disagrees.

"It's still pretty darned deadly. The number of crises is exactly the same as 10 or 20 years ago," he says, attributing the decline in the overall death rate to changes in diet. The hot field now is developing new surgical procedures to tackle atrial fibrillation, a chronic irregular heart rhythm, as well as heart-assist pumps to deal with the growing population of people with congestive heart failure, he says.

For the Magoverns, talking about the future is a lot more fun than talking about the recent past -- especially the subject of Allegheny General's disastrous rise and fall in the 1990s under its rogue chairman, Sherif Abdelhak.

While others left the hospital in droves, Magovern Sr. notes, somewhat painfully, that he didn't abandon faith in Abdelhak until a bit later than his other colleagues. "It was very traumatic."

Today, though, Allegheny General, in its partnership with The Western Pennsylvania Hospital, is doing well again. So is its heart program, which Magovern Jr. claims has performed more open heart surgeries during the past 10 years than any other hospital in the region. And Magovern Sr. is still in the thick of it.

"I'm still working, I'm still listening to my sons, and giving them advice," he says with another chuckle.

"And it seems to me they're doing all right at Allegheny."


Mackenzie Carpenter can be reached at mcarpenter@post-gazette.com or 412-263-1949.

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