His achievements in heart surgery include the implantation of the first long-term LVAD, the pulsatile HeartMate I in 1986, and the replacement of a diseased heart with a continuous flow device using two HeartMate II pumps, in 2011. His most significant achievements have been in the development of the non-pulsatile implantable LVADs, the Jarvik, HeartMate II and HeartWare.
In 1963, Frazier entered medicine at Baylor College of Medicine (BCM) on completion of a degree in history from the University of Texas-Austin. Under the mentorship of at first Michael E. DeBakey at BCM, and then Denton Cooley at the THI, he performed research on the testing of LVADs as a form of MCS. He continued to lead and become significantly influential in heart surgery and the development and clinical implementation of LVADs and his surgical career at the THI has spanned over fifty years.
Oscar Howard Frazier Jr. was born and grew up in Stephenville, Texas, in a Methodist household. Both his parents were teachers[1][2] and his grandfather nicknamed him "Bud" after a distant cousin who was killed in a West Texas saloon shootout at the turn of the nineteenth century.[1]
A "former high school football star",[3] he was initially destined for a career in football,[2] having been asked by Darrell Royal to play for the University of Texas at Austin as a kicker.[1] However, after attending only a few two-a-day football practices, a leg injury ended his football career.[2] Despite this, he later became a black belt in Karate.[2]
Frazier, at first gained admission to study history and literature at law school,[1] but switched to medicine, after being influenced by the writings of Anton Chekhov and William Carlos Williams.[1][2][4] Interviewed for medicine on the 4 July, he won a place at Baylor College of Medicine, atypically on the ability to answer a question on history.[1] He subsequently completed his BA degree in history from the University of Texas-Austin in 1963 before commencing medical education.[5]
In 1966, at the age of 25, while still a medical student of DeBakey, who he described as a “tough taskmaster”,[8] an experience with a teenager who had just had an aortic valve repair, left a lasting impression on him. Frazier was required to manually massage the teenager's heart following a cardiac arrest.[9] He has since repeatedly recounted "that as long as I was massaging that kid's heart, he would wake up... I thought then, and I've often returned to this: If my hand can keep this kid alive, why couldn't we make a device to do the same?"[10] It was this incident and the experience with DeBakey's research that instilled his interest in cardiac surgery and MCS's.[6]
Of the twenty four students that Frazier started his residency with, only five were left. DeBakey, intolerable of error, fired most.[1]
Upon graduating with an MD in 1967, he also received the DeBakey Award for Outstanding Surgical Student[11] before then completing his residency at Baylor Affiliated Hospitals in 1968.[5]
Vietnam
Frazier served in the United States Army from 1968 to 1970 and distinguished himself as a flight surgeon in the U.S. Army 48th Assault Helicopter Company in the Vietnam War.[5] Once, he was shot down and on return to the States, has described how demoralised he felt about what men were capable of during war.[1]
For his achievements, he received three medals, the Combat Flight Medal, Vietnamese Navy Medal, and the Vietnamese Distinguished Service Medal.[2]
Surgical career
After Vietnam, Frazier returned as a surgical resident to BCM.[5]
He remained at BCM until 1974 when he gravitated towards LVAD-research at the near-by THI and subsequently joined Baylor's new rival Cooley, at the THI for further surgical training, which he completed in 1976.[5][7][11]
Left ventricular assist devices (LVAD) and total artificial hearts (TAH)
Throughout the 1970s and 1980s, he continued experimental work toward the development of the implantable long-term pulsatile HeartMate I LVAD.[6][12] In 1976, he worked with John C. Norman and the first intra-abdominal LVAD.[12] In 1985, during his tenure on the advisory board of the National Heart, Lung, and Blood Institute (NHLBI), Frazier recommended that research be initiated on a TAH that would be fully implantable and that would allow people to be discharged and to live a normal lifestyle.[13] In 1986, Frazier successfully used the HeartMate I LVAD in a person with severe irreversible heart failure who was waiting for a heart transplant. Driven by compressed air, the HeartMate LVAD had a textured blood-contacting inner surface, in contrast to a smooth surface. This encouraged a living lining of endothelial cells resembling the inner surfaces of arteries and veins and hence required less blood thinning drugs.[6][11][12]
Over the course of four decades, his work in the field of other LVAD prototypes, continued with experimental studies that resulted in the first intravascular, implantable, continuous-flow pump (Hemopump), which he first implanted into a human in April 1988.[13][14]
When funding for TAH research was restored in January 1991, Frazier became involved in further animal experiments.[13] In 1994, he instigated research on the HeartWare LVAD and described the first long-term clinical use of a LVAD. This person was the first to make hospital discharge with a LVAD.[11] His most significant contribution was the development of the nonpulsatile implantable LVADs, the Jarvik, HeartMate II and HeartWare.[6] After more than ten years of research, in 2000, he performed the first implant of the Jarvik 2000 LVAD into a human, also a continuous flow pump.[1]
By the end of 2013, Frazier and his THI team had implanted their 1,000th LVAD, more than fifty years after Cooley founded the THI and just short of fifty years after DeBakey at BCM was awarded the original NHI grant for the development of an artificial heart.[11][15] His innovations in the surgical treatment of severe heart failure, heart transplantation and MCS to be used either to substitute for or to assist the pumping action of the human heart led to the THI gaining a reputation as a global leader of transplantation and MCS programmes. Frazier performed more than 1,300 heart transplants and implanted 1,000 LVADs, exceeding the performance of any other contemporary surgeon in the world during his career.[6][12]
Successful implantation of a continuous flow device
‘Heartmate’ left ventricular-assist device, United States Wellcome L0066304
In March 2011, Craig Lewis was suffering from amyloidosis and not eligible for heart transplant due to the severity and extent of the disease, affecting also his kidney and liver. Unsuitable for a heart transplant, temporary mechanical TAH or LVAD, his small diseased heart was replaced with a continuous flow device, a pair of HeartMate II pumps, an apparatus of two pumps embraced together, following six years of research on more than fifty calves at the Texas Institute. He awoke from a coma and spent the last five weeks of his life interacting with his family. During the following year, Frazier and his colleague William Cohn engaged with the public and professionals on their experiences. Their TEDMED talk introduced them to Daniel Timms, who was driven to find a technological resolution and whose father had died of heart failure. Timms had an idea and sought out Frazier and Cohn in the States. The surgeons became interested, particularly with the idea that Timms's device had the potential to be a small size. Trialed in numerous calves between 2013 and 2016, some were able to run a treadmill after implantation.[16][17]
He was a chairman of the federal affairs committee for the American Society for Artificial Internal Organs and served on other prominent national committees, including the education committee of the American Society of Transplant Surgeons[citation needed] and the advisory board of the NHLBI.[13]
Medical honors include the Living Legend Award from the World Society of Cardiothoracic Surgeons, BCM Distinguished Alumnus Award, University of Texas Distinguished Alumnus Award, the Gift to Mankind Award from the American Organ Transplant Association, the Distinguished Surgeon Award from the Houston Surgical Society, Honored Physician Award from the American Heart Association Guild, the Ray C. Fish Award for Scientific Achievement from the Texas Heart Institute[19] and the Denton A. Cooley Cardiovascular Surgical Society International Recognition Award. In 2014, Dr. Frazier was presented with the Lifetime Achievement and Distinguished Faculty Award from the Michael E. DeBakey department of surgery at BCM. Frazier's award presentation preceded keynote speaker, former Vice President Dick Cheney, whose life was extended by the technology Frazier helped to develop.[24]
In 2018, the ISHLT awarded Frazier with their ISHLT Lifetime Achievement Award in acknowledgement of his work on severe heart failure, heart transplantation and mechanical circulatory support.[6]
In 2021, the American Association for Thoracic Surgery (AATS) distinctly honored Frazier with the Scientific Achievement Award, the highest recognition the Association can bestow.[26] Previous recipients include Dr. Michael DeBakey, Dr. Denton Cooley, and Sir Magdi Yacoub.[27]
Published in 2018, a book entitled Ticker, recounts the story of Frazier's task to construct a sustainable totally implantable artificial heart.[28] The author describes Frazier sharing traits with pioneers in other fields[29] and how for over half a century been driven by the desire to save lives.[28] In response, reviewers have either been intrigued to what drives Frazier[28] or have debated the ethics surrounding TAHs and LVADs.[29]
Controversies
In 2018, ProPublica and the Houston Chronicle published an investigation into Frazier, claiming that he had been "accused of violating federal research rules and skirting ethical guidelines, putting his quest to make medical history ahead of the needs of some patients."[30] Frazier subsequently sued the authors of the investigation, as well as ProPublica and the Houston Chronicle, for defamation, claiming that articles written about him had contained misleading statements "calculated to falsely portray Dr. Frazier as an inhumane physician."[31] The back-and-forth legal battle came to a close in 2024, when a Texas state appeals court ordered the lawsuit dismissed.[32]
Personal and family
Frazier has previously led Sunday school and collects rare books.[2] He is married to Rachel, and they have two children, Todd, who graduated from the Juilliard School of Music and became a composer, and Allison, a writer.[1]
Selected publications
Frazier, O.H. (1996). "Evolution of battery-powered, vented left ventricular assist devices". The Annals of Thoracic Surgery. 61 (1): 393–395. doi:10.1016/0003-4975(95)00945-0. PMID8561612.
Norman, John C. (1981). "Intracorporeal (Abdominal) Left Ventricular Assist Devices or Partial Artificial Hearts". Archives of Surgery. 116 (11): 1441–5. doi:10.1001/archsurg.1981.01380230059009. PMID7305657..
William Castle DeVries is an American cardiothoracic surgeon, mainly known for the first transplant of a TAH using the Jarvik-7 model.
An artificial heart is an artificial organ device that replaces the heart. Artificial hearts are typically used to bridge the time to complete heart transplantation surgery, but research is ongoing to develop a device that could permanently replace the heart in the case that a heart transplant is unavailable or not viable. As of December 2023, there are two commercially available full artificial heart devices; in both cases, they are for temporary use, of less than a year, for total heart failure patients awaiting a human heart to be transplanted into their bodies.
Michael Ellis DeBakey was an American general and cardiovascular surgeon, scientist and medical educator who became Chairman of the Department of Surgery, President, and Chancellor of Baylor College of Medicine at the Texas Medical Center in Houston, Texas. His career spanned nearly eight decades.
Baylor College of Medicine (BCM) is a medical school and research center in Houston, Texas, within the Texas Medical Center, the world's largest medical center. BCM is composed of four academic components: the School of Medicine, the Graduate School of Biomedical Sciences; the School of Health Professions, and the National School of Tropical Medicine.
Denton Arthur Cooley was an American cardiothoracic surgeon famous for performing the first implantation of a total artificial heart. Cooley was also the founder and surgeon in-chief of The Texas Heart Institute, chief of Cardiovascular Surgery at clinical partner Baylor St. Luke's Medical Center, consultant in Cardiovascular Surgery at Texas Children's Hospital and a clinical professor of Surgery at the University of Texas Health Science Center at Houston.
A ventricular assist device (VAD) is an electromechanical device that provides support for cardiac pump function, which is used either to partially or to completely replace the function of a failing heart. VADs can be used in patients with acute or chronic heart failure, which can occur due to coronary artery disease, atrial fibrillation, valvular disease, and other conditions.
Daoud Anastas Hanania is a Jordanian heart surgeon. Hanania is a former Lieutenant General in the Jordanian Armed Forces and former Senator in the Jordanian Parliament.
Pierre Rene Grondin, was a Canadian cardiac surgeon who was one of the first doctors to perform a successful heart transplant. He brought many innovations to the Montreal Heart Institute after his post-graduate training with pioneers Michael DeBakey and Denton Cooley in Houston, Texas. He was one of a select few heart surgeons worldwide who participated in the development of open-heart surgery using the heart-lung machine in the early 1960s. He performed the first successful heart transplantation in Canada at the Montreal Heart Institute in May 1968.
Domingo Santo Liotta was an Argentine surgeon and pioneer of heart surgery who created multiple cardiac prostheses, including the first total artificial heart.
Norman Edward Shumway was a pioneer of heart surgery at Stanford University. He was the 67th president of the American Association for Thoracic Surgery and the first to perform an adult human to human heart transplantation in the United States.
Charles D Fraser, Jr. is the medical director and surgeon of the Texas Center for Pediatric and Congenital Heart Disease at Dell Children's Medical Center. Formerly, Fraser was chief of congenital heart surgery and cardiac surgeon-in-charge at Texas Children's Hospital, the nation's largest pediatric hospital, served as chief of the Congenital Heart Surgery Division at Baylor College of Medicine, and director of the Adult Congenital Heart Surgery Program at the Texas Heart Institute.
James K. Kirklin is an American cardiac surgeon who has made significant scientific and surgical contributions in the fields of heart transplantation and mechanical circulatory support devices to assist the pumping action of the heart. He was formerly Professor of Surgery (1987-2022), Director of the Division of Cardiothoracic Surgery (2006-2016), Director of the James and John Kirklin Institute for Research in Surgical Outcomes (KIRSO) (2016–2022), and Co-Director of Comprehensive Cardiovascular Center (2011-2017) at the University of Alabama at Birmingham (UAB). While at UAB, he held the UAB Cardiovascular Research Chair (1998-2006), the John Kirklin Chair of Cardiovascular Surgery (2006-2017), and the James Kirklin Chair of Cardiothoracic Surgery (2017-2022).
Sharon Ann Hunt is a cardiology professor and Director of the Post Heart Transplant Programme in Palo Alto, California and is affiliated with Stanford University Medical Center, professionally known for her work in the care of patients after heart transplantation.
ReliantHeart, Inc. is a privately held American company headquartered in Houston, Texas that designs, manufactures, and provides remote monitoring capabilities for its left ventricular assist devices which are used to assist circulation for failing hearts.
Michael J. Reardon is an American cardiac surgeon and medical researcher. He is known for his work in heart autotransplantation for malignant heart tumors, an operation in which the surgeon removes the patient's heart, cuts out the malignant tumor, and reimplants the heart back in the patient's chest. He performed the first successful heart autotransplantation for a cancerous heart tumor in 1998.
St. Luke's Health is a health system located in the Greater Houston area. It is a part of one of the largest health systems and the second largest faith-based health system in the United States, Catholic Health Initiatives. CHI St. Luke's Health's facilities have been recognized as some of the best in the nation.
The International Society for Heart and Lung Transplantation (ISHLT), established in 1981, is a professional organization committed to research and education in heart and lung disease and transplantation. It holds annual scientific meetings and publishes The Journal of Heart and Lung Transplantation. It also holds the worlds largest registry of heart and lung transplant data.
Jack Greene Copeland is an American cardiothoracic surgeon, who has established procedures in heart transplantation including repeat heart transplantation, the implantation of total artificial hearts (TAH) to bridge the time to heart transplant, innovations in left ventricular assist devices (LVAD) and the technique of "piggybacking" a second heart in a person, while leaving them the original.
Eric A. Rose is an American cardiothoracic surgeon, scientist, entrepreneur and professor and Chairman of the Department of Population Health Science & Policy, and Associate Director for Clinical Outcomes at Mount Sinai Heart. He is best known for performing the first successful paediatric heart transplant, in 1984 while at NewYork–Presbyterian Hospital (NYP).
Keith Reemtsma was an American transplant surgeon, best known for the cross-species kidney transplantation operation from chimpanzee to human in 1964. With only the early immunosuppressants and no long-term dialysis, the female recipient survived nine months, long enough to return to work.
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