Thomas J. Fogarty

Last updated
Dr. Thomas J. Fogarty
Born (1934-02-25) February 25, 1934 (age 90)
Cincinnati, Ohio
NationalityAmerican
Known for inventor, winemaking
Notable work Hancock Aortic Tissue Valve

Dr. Thomas J. "Tom" Fogarty (born February 25, 1934, in Cincinnati, Ohio) is an American surgeon and medical device inventor. He is best known for the invention of the embolectomy catheter (or balloon catheter), which revolutionized the treatment of blood clots (embolus).

Contents

In 2008, Fogarty was elected a member of the National Academy of Engineering for invention of the balloon catheter and devices that have revolutionized vascular surgery, and for creating companies to commercialize these inventions. [1]

Early life and education

Fogarty was born in Cincinnati, Ohio, on February 25, 1934. His father worked as a railroad engineer, but died when Fogarty was eight years old. He was born into an Irish-Catholic family. [2]

Fogarty cites his father's absence as being influential in his own creative nature as an inventor. He fixed things that needed to be fixed for his mother, and he worked with soapbox derby cars and model airplanes. "I just had a natural inclination and inquisitive nature about building things. I looked at things and just naturally thought, 'Okay, how can I make this better?'" [3] His business side was evident in childhood as well. The model airplanes that he built were sold to neighborhood kids. When he became frustrated with motor scooter gears, he built and sold a centrifugal clutch. [4]

Fogarty was not a good student, and his original career goal was to be a boxer. “I wasn’t a very good kid. They sent me to a camp to keep me out of trouble. One of the routine activities was boxing." [5]

To help his family get by in the late 1940s, Fogarty started working at Good Samaritan Hospital, beginning with cleaning medical equipment while he was in the eighth grade at school. [6] He continued working during his high school summer vacations and was soon promoted to scrub technician, a person who handed medical instruments to surgeons – he witnessed his first surgery at a young age. It was during this time that he first met Dr. Jack Cranley, who would have a major influence on Fogarty's future career. [7]

During his last year of high school, Fogarty discovered that he wanted to be a doctor. At the age of 17, he quit his boxing career after he broke his nose in a match that ended in a draw. A family priest gave him a recommendation, and because of his awful grades, he was admitted to Cincinnati's Xavier University on probation. [5] Jack Cranley, one of the most prominent vascular surgeons in the United States became his mentor. Speaking of Cranley, Fogarty later stated: “I had a mentor who encouraged me and helped to persuade me to go to college… He had 10 kids and I became the 11th. He always told me, ‘You are smarter than you think.’” [5]

Fogarty graduated from Xavier University with a bachelor’s degree in biology in 1956 and went on to attend the University of Cincinnati College of Medicine, where he graduated summa cum laude in 1960. From 1960 to 1961, he interned at the University of Oregon Medical School in Portland, Oregon, and he completed his surgical residency at the same school in 1965.

Invention of the embolectomy catheter

During Fogarty’s years at Good Samaritan Hospital, he witnessed the deaths of many patients who died from complications in blood clot surgeries in their limbs. “Fifty percent of the patients died. I thought there must be a better way.” [8] Before Fogarty's invention, surgeons had to use forceps to remove the blood clots only after a huge part of an artery had been cut open, and the patient would be under general anesthesia for hours. Blood flow is usually interrupted in the procedure, increasing the risk of the patient losing a limb. [9]

At home, the ideas that went through Fogarty's head concerned different ways of making the procedure better, and he especially concentrated on avoiding the risky incisions. He tinkered with a urethral catheter and a balloon in his attic. Because a catheter only required a small incision, it would be able to get to the clot without much trauma to the patient. The urethral catheter is also flexible yet strong enough to be pushed through a blood clot. As for the balloon, he basically cut off the tip of the pinky finger of a size 5 surgical latex glove and attempted to incorporate it onto the end of the catheter. [6] The resulting balloon could be inflated with saline using a syringe, and once it expands to the size of the artery, it is then retracted, withdrawing the clot through the artery and out the incision.

The main problem in building this device was the way the balloon could be attached to the catheter. Glue that could hold vinyl, the material making up a catheter, and latex, the type of glove used, was not available. Fogarty's own take on the catheter came about because of fishing techniques he learned as a child. Precise hand-tying was needed in fly-fishing, and with these techniques, he tied the balloon to the catheter. "I'd always tied flies and made lures so it was just a natural thing." [3] [9] His experimental balloon catheter, however, always seemed to burst when it was over inflated. It even broke when he dragged it through glass tubes filled with Jell-o, a model he thought simulated a clot within an artery. After some time, he figured out the type and thickness of rubber that was firm enough when inflated to extract a clot and still flexible enough to move through without breaking. The device, made before Fogarty even received his MD from University of Cincinnati in 1960, became the first minimally invasive surgical device.

Fogarty, however, came across difficulties in getting a manufacturer to produce it. From 1959 to 1961, nobody was willing to help. "Companies thought I was some stooge fooling around. I didn't have any credibility." [9] Dr. Cranley continued to encourage him, and soon, during his fellowship training at the University of Cincinnati in 1961 and 1962, Fogarty started to make the catheter system by hand for himself and for other vascular surgeons.

At the University of Oregon, while Fogarty was completing his residency in surgery, Dr. Al Starr, head of the cardiothoracic division, used Fogarty's balloon catheters. After he was informed that no company was willing to manufacture Fogarty's device, he asked one of his acquaintances, Lowell Edwards, an electrical engineer and president of his own company, to give the device consideration in producing it. In 1969, Fogarty patented his device, and Edwards Life Sciences from Irvine, California, was assigned the patent to begin manufacturing the Fogarty embolectomy catheter.

Because of the decreased risk associated with the device, Fogarty's balloon catheter became the industry standard and remains the most widely used catheter for blood-clot removal. Before his invention the success rate for removing an embolus, or blood clot, was forty to fifty percent. The balloon catheter is now[ citation needed ] used in over three hundred thousand procedures every year all over the world, and is estimated to have saved the lives and limbs of approximately twenty million patients. [10]

Other inventions

Numerous sequel applications of Fogarty's catheter came about. The first balloon angioplasty, for example, was performed with a Fogarty catheter in 1965, and has led to over six hundred fifty thousand such operations per year. Fogarty has also modified his catheter to less invasive biopsy techniques.

After completing his residency and becoming a cardiovascular surgeon, Fogarty continued to invent new medical devices. One of his most successful products is the Stent-Graft, which dealt with the difficult problem of abdominal aortic aneurysms (a term referring to a weakened blood vessel). The old method was to remove the bad part of a weakened blood vessel, but Fogarty's idea was to support it with an implant. He used a stent, a thin polyester tube that grabs onto the blood vessels. A catheter transports the stent to the weakened blood vessel, and once the balloon is inflated, the stent expands to the size of the blood vessel, and blood flows normally.

Fogarty's other inventions include Fogarty surgical clips and clamps, which are used by cardiac and vascular surgeons to temporarily occlude vessels during surgery. Working with Warren Hancock, he is co-inventor of the Hancock tissue heart valve – the world's first porcine valve. [4]

Fogarty's own inventions and the many others that resulted from his original embolectomy catheter heavily influenced the way surgery was performed. Considered one of the pioneers of minimally-invasive surgery, Fogarty has said: "I had no concept that [non-invasive surgery] would reach the magnitude that it has." [3]

As a result of the embolectomy catheter and other inventions, Dr. Fogarty has won many prizes, including the Presidential National Medal of Technology and Innovation, the country's highest honor for achievement and leadership in advancing the fields of science and technology, in 2014; [11] the National Medal for Technology and Innovation in 2012; [10] and a Lifetime Achievement Award from the Advanced Medical Technology Association (AdvaMed) in 2015. [12] He has published around 180 scientific articles and textbook chapters in the fields of general and cardiovascular surgery. [13] He served as president of the Society for Vascular Surgery from 1995 to 1996.

Innovation and entrepreneurship

Fogarty founded Fogarty Engineering, Inc. in 1980, to promote ideas for new medical devices, and has founded/co-founded and chaired the board for many business and research companies based on devices developed at the company. [8]

In 1993, with Mark Wan and Wilfred Jaeger, he founded Three Arch Partners, a venture capital fund to invest in new technology and medical devices. [14] [15]

As a pioneer and supporter of innovation in medical technology, Fogarty has acquired over 160 patents for his medical work. [12] [16] He is associated with numerous medical technology companies and was appointed as an independent director to the Board of Pulse Biosciences in 2017. He is managing director of early-stage life science accelerator Emergent Medical Partners.

Fogarty Institute for Innovation

Fogarty left Stanford Medical School after about fourteen years as a professor and practicing cardiovascular surgeon. In September 2007, at Mountain View, California, he founded the Thomas Fogarty Institute for Innovation. It occupies forty-five hundred square feet of offices and engineering labs on the campus of El Camino Hospital. The educational, non-profit organization mentors and trains medical innovators. The idea for the institution dates back to Fogarty's early life when he received encouragement from Dr. Jack Cranley. [5]

“We are teaching people (doctors and engineers) how to get their concepts and products into use. Very few have gone through the process of coming up with a concept and getting it funded. That does not come naturally. It comes through experience. We will teach how to address these challenges.” [5] Physician innovators, including Fogarty, serve as the faculty of the Institute and make use of their networks and experiences in the private industry to help those with projects that are ready for commercialization.

Thomas Fogarty Winery and Vineyards

In 1969, when he began teaching surgery at the Stanford University Medical Center, Fogarty was first introduced to wine. He helped out at a Stanford colleague's small winery. Later on, he purchased land in the Santa Cruz Mountains. He established a cellar there and began making wine with grapes bought from nearby growers. With help from founding winemaker Michael Martella, he planted his first vines in 1978 and set up a commercial winery, Thomas Fogarty Winery and Vineyards, in 1981, largely in order to share a business with his family. The estate now[ when? ] has thirty acres under vine, which are farmed organically. [17]

The winery is run today[ when? ] by Tom Fogarty, Jr and the Fogarty family with production overseen by Winegrower Nathan Kandler. The younger Fogarty is widely credited for introducing a line of kosher-for-Passover sweet wines to the Portola Valley winemaking region. It has become well known as a top producer of single-vineyard Pinot Noir and Chardonnay wines. Thomas Fogarty Winery was named by Wine and Spirits magazine as one of its top 100 wineries in 2014. [18]

Awards

Affiliated organizations

Related Research Articles

<span class="mw-page-title-main">Angioplasty</span> Procedure to widen narrow arteries or veins

Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis.

<span class="mw-page-title-main">Catheter</span> Medical tubes inserted in the body to extract or administer substances

In medicine, a catheter is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Catheters are manufactured for specific applications, such as cardiovascular, urological, gastrointestinal, neurovascular and ophthalmic procedures. The process of inserting a catheter is called catheterization.

<span class="mw-page-title-main">Stent</span> Type of medical device

In medicine, a stent is a tube usually constructed of a metallic alloy or a polymer. It is inserted into the lumen of an anatomic vessel or duct to keep the passageway open. Stenting refers to the placement of a stent. The word "stent" is also used as a verb to describe the placement of such a device, particularly when a disease such as atherosclerosis has pathologically narrowed a structure such as an artery.

<span class="mw-page-title-main">Interventional radiology</span> Medical subspecialty

Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an imaging contrast agent into a hollow structure, such as a blood vessel or a duct. By contrast, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement, and angioplasty of narrowed structures.

In surgery, a percutaneous procedure is any medical procedure or method where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed.

<span class="mw-page-title-main">Vascular surgery</span> Medical specialty, operative procedures for the treatment of vascular disorders

Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolved from general and cardiovascular surgery where it refined the management of just the vessels, no longer treating the heart or other organs. Modern vascular surgery includes open surgery techniques, endovascular techniques and medical management of vascular diseases - unlike the parent specialities. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system excluding the coronaries and intracranial vasculature. Vascular surgeons also are called to assist other physicians to carry out surgery near vessels, or to salvage vascular injuries that include hemorrhage control, dissection, occlusion or simply for safe exposure of vascular structures.

<span class="mw-page-title-main">Interventional cardiology</span> Catheter-based treatment of structural heart diseases

Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology after the development of angioplasty by interventional radiologist Charles Dotter.

<span class="mw-page-title-main">Surgical instrument</span> Tools designed for use during surgery

A surgical instrument is a medical device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in all sorts of surgeries, while others are designed for only certain specialties or specific procedures.

<span class="mw-page-title-main">Drug-eluting stent</span> Medical implant

A drug-eluting stent (DES) is a tube made of a mesh-like material used to treat narrowed arteries in medical procedures both mechanically and pharmacologically. A DES is inserted into a narrowed artery using a balloon. Once the balloon inside the stent is inflated, the stent expands, pushing against the artery wall, keeping the artery open, thereby improving blood flow. The mesh design allows cells to grow through and around it, securing it in place.

<span class="mw-page-title-main">Atrial septostomy</span> Surgical procedure on the heart

Atrial septostomy is a surgical procedure in which a small hole is created between the upper two chambers of the heart, the atria. This procedure is primarily used to palliate dextro-Transposition of the great arteries or d-TGA, a life-threatening cyanotic congenital heart defect seen in infants. It is performed prior to an arterial switch operation. Atrial septostomy has also seen limited use as a surgical treatment for pulmonary hypertension. The first atrial septostomy was developed by Vivien Thomas in a canine model and performed in humans by Alfred Blalock. The Rashkind balloon procedure, a common atrial septostomy technique, was developed in 1966 by American cardiologist William Rashkind at the Children's Hospital of Philadelphia.

<span class="mw-page-title-main">Pulmonary artery stenosis</span> Medical condition

Pulmonary artery stenosis (PAS) is a narrowing of the pulmonary artery. The pulmonary artery is a blood vessel moving blood from the right side of the heart to the lungs. This narrowing can be due to many causes, including infection during pregnancy, a congenital heart defect, a problem with blood clotting in childhood or early adulthood, or a genetic change.

Embolectomy is the emergency interventional or surgical removal of emboli which are blocking blood circulation. It usually involves removal of thrombi, and is then referred to as thromboembolectomy or thrombectomy. Embolectomy is an emergency procedure often as the last resort because permanent occlusion of a significant blood flow to an organ leads to necrosis. Other involved therapeutic options are anticoagulation and thrombolysis.

Julio Palmaz is a doctor of vascular radiology at University of Texas Health Science Center at San Antonio. He studied at the National University of La Plata in Argentina, earning his medical degree in 1971. He then practiced vascular radiology at the San Martin University Hospital in La Plata before moving to the University of Texas Health and Science Center at San Antonio. He is known for inventing the balloon-expandable stent, for which he received a patent filed in 1985. It was recognized in Intellectual Property International Magazine as one of "Ten Patents that Changed the World" in the last century. His early stent research artifacts are now part of the medical collection of the Smithsonian Institution in Washington, DC. He continues to innovate on his initial designs, developing new endovascular devices.

Fogarty arterial embolectomy catheter is a device developed in 1961 by Dr. Thomas J. Fogarty to remove fresh emboli in the arterial system. It consists of a hollow tube with an inflatable balloon attached to its tip. The catheter is inserted into the blood vessel through a clot. The balloon is then inflated to extract the clot from the vessel. It is available in different lengths and sizes, and is often colour coded by size. Because it is less invasive than ordinary surgery, it reduces the chance of postoperative complications.

Todd E. Rasmussen, MD, FACS is an American professor and Vice Chair for Education in the Department of Surgery at Mayo Clinic, Rochester, and a Senior Associate Consultant in the Division of Vascular and Endovascular Surgery. Prior to joining the Mayo Clinic, he had a 28-year career in the military, retiring as an Air Force Colonel in 2021. His most recent military assignment was as Associate Dean or Research at the Uniformed Services University of the Health Sciences and an attending surgeon at the Walter Reed National Military Medical Center.

<span class="mw-page-title-main">Dinker Belle Rai</span> Indian American surgeon

Dinker Belle Rai is an Indian American vascular surgeon who serves as the chairman of the Department of Surgery and as the Chief of the Department of Vascular Surgery / Vascular Laboratory at the Interfaith Medical Center, Brooklyn, New York. He is a visiting clinical professor at the Health & Science Center of the State University of New York in Brooklyn and a visiting professor at the Rajiv Gandhi University in Bangalore, India. Rai is a Fellow of the American College of Surgeons and a Fellow of the Royal Canadian College of Surgeons. He is credited with developing the first ever method for retrograde catheterization of the venous tree. This invention was given a United States patent in 1988. Based on this patent, a company called The Ideas For Medicine, Inc. manufactured and still distributes out a series of catheters, known as Rai’s Catheters for use in performing descending phlebographic tests and for venous embolectomies. He is also credited with the discovery of the motion of venous valves in human beings. His original research on histopathological specimens of patients with saphenofemoral – incompetency resulted in a paradigm shift in management of varicose veins. He performed the first ever vein transplantation below the knee. The discovery of the right atrial mechanical function is a pivotal discovery in his medical research work. He is an editor for the International Journal of Angiology. Rai has been featured in the book "Jewels of India" for his contributions to medicine, art, sports and cultural arenas.

Juan Carlos Parodi is an Argentinian vascular surgeon who introduced the minimally invasive endovascular aneurysm repair (EVAR) to the world and performed the first successful endovascular repair of an abdominal aortic aneurysm on 7 September 1990 in Buenos Aires. In 1992 he was the first in the United States to perform minimally invasive aortic aneurysm surgery together with Drs. Frank Veith, Michael L. Marin and Claudio J. Schonholz. He continues to develop new techniques, including seat belt and air bag technique for cerebral protection during carotid stenting. He is recognized as a renowned pioneer in the specialty of endovascular repairs of the aorta.

<span class="mw-page-title-main">Christoph Huber</span> Swiss cardiac surgeon

Christoph Huber MD, FMH, FECTS is a Swiss cardiac surgeon who is a professor and the head of the Division of Cardiac and Vascular Surgery at the University Hospital Geneva, Switzerland.

Cesare Gianturco was an Italian-American physician and one of the earliest contributors to the specialty of interventional radiology. After many years as the radiology chief at the Carle Clinic in Illinois and a faculty member at the University of Illinois College of Medicine, Gianturco moved to Houston, where he conducted research at MD Anderson Hospital.

<span class="mw-page-title-main">LeMaitre Vascular</span>

LeMaitre Vascular is an American medical device company established in 1986 by vascular surgeon George D. LeMaitre, and based in Burlington, Massachusetts, which provides devices, implants and human tissue cryopreservation services used by surgeons in the treatment of vascular conditions, particularly peripheral vascular disease. As of 2022, LeMaitre Vascular sells directly to hospitals in 25 countries and through distributors in more than 70 countries throughout North America, Europe and Asia/Pacific Rim.

References

  1. ↑ "Dr. Thomas J. Fogarty". National Academy of Engineering . National Academy of Sciences . Retrieved 8 November 2021.
  2. ↑ "Dr. Thomas J. Fogarty Irish Roots | Irish American Museum of DC". www.irishamericanmuseumdc.org. Retrieved 2024-06-24.
  3. 1 2 3 Brown, David E (2003). "Thomas Fogarty: balloon embolectomy catheter". Inventing Modern America: From the Microwave to the Mouse . Cambridge, Mass.: MIT Press. pp.  12–17. ISBN   9780262025089.
  4. 1 2 "Thomas Fogarty | Lemelson-MIT Program". lemelson.mit.edu. Retrieved 2019-01-30.
  5. 1 2 3 4 5 Writer, John Flood-Town Crier Staff. "A Legend at Heart: Thomas Fogarty brings his inventive clout to El Camino Hopsital [sic]". Los Altos Town Crier. Retrieved 2019-01-30.
  6. 1 2 Riordan, Teresa (2000-05-22). "PATENTS; Two inventors honored for seminal work on the balloon catheter and wireless communications". The New York Times. ISSN   0362-4331 . Retrieved 2019-01-30.
  7. ↑ Brunk, Doug (November 15, 2006). "Physician Inventors Pioneer New Devices". www.mdedge.com. Retrieved 2019-01-30.
  8. 1 2 White, Tracie (Fall 2006). "Father of Invention. What's the master medical device maker's secret?". Stanford Medical Magazine.
  9. 1 2 3 Riggins, Christie (Fall 2000). "Great inventions don't happen overnight: development of the Fogarty balloon catheter". Stanford Medicine. 17 (3).
  10. 1 2 "Thomas J. Fogarty. 2012 National Medal of Technology and Innovation, Medicine". National Science & Technology Medals Foundation. Retrieved January 25, 2019.
  11. ↑ Hospital, Fogarty Institute for Innovation; El Camino. "Dr. Thomas J Fogarty Awarded Presidential National Medal of Technology and Innovation". www.prnewswire.com. Retrieved 2023-04-26.{{cite web}}: CS1 maint: multiple names: authors list (link)
  12. 1 2 "AdvaMed Honors Dr. Thomas J. Fogarty with Lifetime Achievement Award". Advanced Medical Technology Association. October 7, 2015. Retrieved January 25, 2019.
  13. ↑ "Thomas J. Fogarty M.D." Bloomberg. Retrieved January 25, 2019.
  14. ↑ Lenoir, Timothy (2014). "Inventing the entrepreneurial university: Stanford and the evolution of Silicon Valley". In Allen, Thomas J.; O'Shea, Rory P. (eds.). Building Technology Transfer within Research Universities: An Entrepreneurial Approach. Cambridge University Press. p. 110. ISBN   9780521876537.
  15. ↑ "Thomas J. Fogarty | The National Inventors Hall of Fame". www.invent.org. Retrieved 2019-01-30.
  16. ↑ "Thomas Fogarty, MD. Medical pioneer. Patent advocate". Fogarty Institute for Innovation. Retrieved January 25, 2019.
  17. ↑ "Under Vine". Thomas J. Fogarty Winery. Retrieved January 25, 2019.
  18. ↑ "The Wine & Spirits top 100 wineries of 2014". Wine & Spirits. October 3, 2014.

Selected patents


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