On other pages... Robert Anderson, retired professor of paediatric cardiac morphology, Institute of Child Health, University College London, London, England, talks to Mark icholls. European Perspectives in Cardiology European Perspectives in Cardiology f133 Circulation: European Perspectives Circulation June 15, 2010 Pioneer: Robert Anderson, MD, PhD, FRCPath Responsible for Demonstrating the Location of “Invisible” Conduction Tissues Within and Clarifying the Morphology of the Congenitally Malformed Heart Spotlight: Georg M. Wieselthaler, MD Georg M. Wieselthaler, MD, associate professor of surgery in the Department of Cardiothoracic Surgery at the Medical University of Vienna, Vienna, Austria, has spent more than 2 decades pioneering work on heart pumps and circulatory support. He was part of the Viennese team who in 1998 implanted 2 patients with a rotary blood pump who then became the first long-term survivors of the technology and its pulseless pattern of blood flow. Page f136 R esearch conducted by Robert Anderson, MD, PhD, FRCPath, retired professor of paediatric cardiac mor- phology, Institute of Child Health, University College London, London, England, into the anatomy and develop- ment of the normal and congenitally malformed heart has “played a large part in permitting surgeons to improve the results of paediatric cardiac surgery.” Professor Anderson has published on virtually all con- genital cardiac malformations 1,2 but says, “Probably the lesion that we have done most to clarify is atrioventricular septal defect.” 3–5 He is most proud of the work clarifying the morphology of the congenitally malformed heart and demonstrating within the malformed heart the location of the otherwise invisible conduction tissues. However, he looks back at his initial article on the disposition of the conduction tissues in congenitally corrected transposition as one that had the most impact on his work. 6 He explains, “This led the way to many subsequent investigations of the location of the conduction tissues in congenitally mal- formed hearts and indicated the need to understand the mor- phology of the hearts and the normal disposition of the conduction tissues. It has now lent itself to my ongoing studies of the development of the heart and the conduction tissues.” Professor Anderson has found the mechanics of cardiac development 7 to be the most challenging, but adds, “This is now taking shape thanks to the work I have been able to continue in my ‘retirement’.” Left, right-sided heart chambers from a patient with congenitally cor- rected transposition. Professor Anderson’s research showed that the atrioventricular conduction axis was located in front of and superior to an accompanying ventricular septal defect (red arrow) rather than behind and inferiorly, as previously presumed (white arrow with red border). The arrangement had been described in German literature, but had been neglected. Right, an ostium primum defect from the right side, which Professor Anderson showed to be an atrioventricular sep- tal defect extending nearly to the level of the atrioventricular junction (white arrow) with commonality of the atrioventricular junction and fusion of the leaflets of the common valve guarding the junction to the crest of the scooped-out ventricular septum and each other. Shunting through the defect is largely ventricular (red double-headed arrow), and the common valve is divided into right- ventricular and left-ventricu- lar components. Photographs courtesy of Professor Anderson. by guest on May 20, 2018 http://circ.ahajournals.org/ Downloaded from
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On other pages...
Robert Anderson, retired professor of paediatric cardiac morphology, Institute ofChild Health, University College London, London, England, talks to Mark �icholls.
European Perspectives in CardiologyEuropean Perspectives in Cardiology
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Circulation June 15, 2010
Pioneer: Robert Anderson, MD, PhD, FRCPathResponsible for Demonstrating the Location of “Invisible”Conduction Tissues Within and Clarifying the Morphology of theCongenitally Malformed Heart
Spotlight: Georg M. Wieselthaler, MDGeorg M. Wieselthaler, MD, associate professor of surgery in the Departmentof Cardiothoracic Surgery at the Medical University of Vienna, Vienna, Austria,has spent more than 2 decades pioneering work on heart pumps and circulatorysupport. He was part of the Viennese team who in 1998 implanted 2 patientswith a rotary blood pump who then became the first long-term survivors ofthe technology and its pulseless pattern of blood flow. Page f136
Research conducted by Robert Anderson, MD, PhD,FRCPath, retired professor of paediatric cardiac mor-
phology, Institute of Child Health, University CollegeLondon, London, England, into the anatomy and develop-ment of the normal and congenitally malformed heart has“played a large part in permitting surgeons to improve theresults of paediatric cardiac surgery.”Professor Anderson has published on virtually all con-
genital cardiac malformations1,2 but says, “Probably thelesion that we have done most to clarify is atrioventricularseptal defect.”3–5 He is most proud of the work clarifyingthe morphology of the congenitally malformed heart anddemonstrating within the malformed heart the location ofthe otherwise invisible conduction tissues. However, helooks back at his initial article on the disposition of theconduction tissues in congenitally corrected transpositionas one that had the most impact on his work.6 He explains,“This led the way to many subsequent investigations of thelocation of the conduction tissues in congenitally mal-formed hearts and indicated the need to understand the mor-phology of the hearts and the normal disposition of theconduction tissues. It has now lent itself to my ongoingstudies of the development of the heart and the conductiontissues.” Professor Anderson has found the mechanics ofcardiac development7 to be the most challenging, but adds,“This is now taking shape thanks to the work I have beenable to continue in my ‘retirement’.”
Left, right-sided heart chambers from a patient with congenitally cor-rected transposition. Professor Anderson’s research showed that theatrioventricular conduction axis was located in front of and superiorto an accompanying ventricular septal defect (red arrow) rather thanbehind and inferiorly, as previously presumed (white arrow with redborder). The arrangement had been described in German literature,but had been neglected. Right, an ostium primum defect from the rightside, which Professor Anderson showed to be an atrioventricular sep-tal defect extending nearly to the level of the atrioventricular junction(white arrow) with commonality of the atrioventricular junction andfusion of the leaflets of the common valve guarding the junction to thecrest of the scooped-out ventricular septum and each other. Shuntingthrough the defect is largely ventricular (red double-headed arrow),and the common valve is divided into right- ventricular and left-ventricu-lar components. Photographs courtesy of Professor Anderson.
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A Damascene Moment “Transformed My Career”Born in Wellington, Shropshire, England, in April 1942,Professor Anderson was educated at the grammar school inthe town from 1952 to 1960 before studying medicine, withan intercalated degree in anatomy, at the University ofManchester, England, qualifying BSc in 1963, and MBChB in 1966. He initially intended to become an ophthal-mologist, but instead returned to the Anatomy Department,where he had carried out the work for his BSc thesis, andbecame “consumed with cardiac anatomy.”A chance encounter then led to a Damascene moment
and the work that would prove so influential to the practiceof paediatric cardiology and cardiac surgery. He says,“While I was still at an early stage, someone showed me asection from a child undergoing surgery in Liverpool[England] and sadly dying. The surgeon had put a stitcharound the conducting bundle between the atrial andventricular chambers. This was my introduction to thecongenitally malformed heart.” The Liverpool team madeit possible for him to begin his combined studies of the con-genitally malformed heart and the conduction tissues.8The support provided by Anderson’s chief, George
Mitchell, OBE, FRCS, inManchester, and the cardiac surgeonDavidHamilton, FRCS, in Liverpool, led to aMedical ResearchCouncil (MRC) Travelling Fellowship at the University ofAmsterdam, Amsterdam, the Netherlands, in 1973.Professor Anderson recalls, “This initial introduction
heralded the research that got me to Amsterdam, and letone thing happen after another. The experience transformedmy career. With the MRC Travelling Fellowship, I cameinto contact with Professor Durrer [MD], who was my ini-tial mentor. He supported me strongly in Amsterdam andmade it possible for me to work with Giel Janse, MD.Needing pathological material, I was then introduced toAnton Becker [MD]. This started a collaboration that hasextended throughout my career. My initial researchinvolved the conduction tissues in the heart and also
included studies of the developing heart. On the basis ofthis work, we rediscovered parts of the conduction tissuethat had been described by German pathologists, but thenforgotten. These findings proved of huge significance forpaediatric cardiac surgeons. Elliot Shinebourne [MD,FRCP] heard me present this work and asked whether Iwould work with him as a clinical anatomist. With his sup-port I was able to become a full-time professional clinicalcardiac anatomist. This gave me the opportunity to use myanatomical skills and expertise in a clinical setting and beremunerated at clinical rates.”With funding arranged through the Joseph Levy and
British Heart Foundations, Professor Anderson acceptedthe role that provided the basis of his career as professor ofpaediatric cardiac morphology. He says it effectively“cemented the remainder” of his career, with 25 years spentat the Royal Brompton Hospital and the final 8 years atGreat Ormond Street Hospital Institute of Child Healthuntil his retirement. He says, “Throughout this period, Imaintained my active collaboration withAnton Becker, andtogether we published articles on the morphology of mostcongenital cardiac malformations.”9He says, “As an anatomist, the ‘pathology’ of congeni-
tal cardiac disease was a relatively open book because it ismostly deranged anatomy. Thus, my initial training inanatomy set me up ideally to become an expert in the struc-ture of the congenitally malformed heart, which proved tobe a largely unpopulated area. My collaboration with allmy clinical colleagues made it possible to perform the cru-cial clinicomorphological correlations that have been thebedrock of my career.”Now in ‘retirement,’ Professor Anderson continues his
research with colleagues. Since 2007, he has been emeritusprofessor, University College London; emeritus visitingprofessor, University of Manchester; professorial fellow,Institute of Human Genetics, Newcastle University,Newcastle, England; and visiting professor of paediatrics,Medical University of South Carolina, Charleston, SC,where he teaches fellows paediatric cardiology. He alsoretains his collaborations with colleagues at the Universityof Pittsburgh, Pittsburgh, Penn, and has established impor-tant new collaborations at the University of Florida,Gainesville, Fla, and the Children’s Memorial Hospital,Chicago, Ill.
“I Would Like to Be Able to Translate My Expertise inthe Structure of Congenitally Malformed Hearts IntoElucidating Their Morphogenesis”Professor Anderson was instrumental in establishing theBritish Congenital Cardiac Association, and was presidentfrom 1999 to 2001. He is also involved with the BritishCardiovascular Society, the European Society forCardiology, the Anatomical Society, the InternationalNomenclature Committee, and the World Society forPaediatric Cardiac Surgery. He is an honorary fellow of theAssociation for European Paediatric Cardiology and theEuropean Association for Cardiothoracic Surgery.
Professor Anderson with his wife,Christine, whom he married in 1966.They live in Wandsworth, London,England, and have 2 children and 3grandchildren. Apart from medicine,he enjoys music and playing thepiano. He says, “I am fortunate tohave very good friends who are trulysuperb musicians, and they suffermy poor playing as we explore thepiano trios and quartets of Haydnand Mozart.” An avid golfer, as isChristine, Professor Anderson retainsa handicap of 14, having got downto 4 at one time, and now enjoysplaying at Walton Heath, Walton onthe Hill, Surrey, England, and “themany fine courses” in South Carolina.He also enjoys fine wine. Photo-graph courtesy of Professor Anderson.
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Along with Bill Henry, MD, Professor Anderson foundedthe journal Cardiology in the Young, and was editor-in-chiefuntil 2 years ago. He adds, “While working at the RoyalBrompton, I was able to collaborate with colleagues workingat Great Ormond Street and Guy’s Hospital, and this collabo-ration led to us producewhat is now recognised as the foremosttextbook in paediatric cardiology, now in its third edition.”10Professor Anderson has received several special awards
including the Excerpta Medica Travelling Award (1977),the Thomas Lewis Gold Medal of British Cardiac Society(1982), the British Heart Foundation Prize for Cardio-vascular Research (1984), and the JamesMackenzie LifetimeAward of the British Cardiovascular Society (2007).Within his own field of work, Professor Anderson
believes the major developments will be in cardiac embry-ology. He says, “The developments in cardiac embryologyare truly spectacular. I would like to be able to translate myexpertise in the structure of congenitally malformed heartsinto elucidating their morphogenesis.”He advises young people wanting to follow a career in
medicine or cardiology to “work hard and develop anexcellent research portfolio.” As for his own future, hisambitions are a blend of personal and professional: “to con-tinue research and teaching; to drink more fine wine; tomaintain my golf handicap; and to improve my piano play-ing so as to include the chamber works of Beethoven,Schubert; and Schumann.”
References1. Anderson RH, BeckerAE, Freedom RM, Macartney FJ, Quero JimenezM, Shinebourne EA, Wilkinson JL, Tynan M. Sequential segmentalanalysis of congenital heart disease. Pediatr Cardiol. 1984;5:281–288.
2. Anderson RH, Becker AE, Tynan M, Macartney FJ, Rigby ML,Wilkinson JL. The univentricular atrioventricular connection: getting tothe root of a thorny problem. Am J Cardiol. 1984;54:822–828.
3. Piccoli GP, Gerlis LM, Wilkinson JL, Lozsadi K, Macartney FJ,Anderson RH. Morphology and classification of atrioventriculardefects. Br Heart J. 1979;42:621–632.
4. Penkoske PA, Neches WH, Anderson RH, Zuberbuhler JR. Furtherobservations on the morphology of atrioventricular septal defects. JThorac Cardiovasc Surg. 1985;90:611–622.
5. Anderson RH, Ho SY, Falcao S, Daliento L, Rigby ML. The diagnosticfeatures of atrioventricular septal defect with common atrioventricularjunction. Cardiol Young. 1998;8:33–49.
6. Anderson RH, Becker AE, Arnold R, Wilkinson JL. The conducting tis-sues in congenitally corrected transposition. Circulation. 1974;50:911–923.
7. Anderson RH, Webb S, Brown NA, Lamers W, Moorman A.Development of the heart: formation of the ventricular outflow tracts,arterial valves, and intrapericardial arterial trunks. Heart. 2003;89:1110–1118.
8. Latham RA, Anderson RH. Anatomical variations in atrioventricularconduction system with reference to ventricular septal defects. BrHeart J. 1972;34:185–190.
9. Becker AE, Connor M, Anderson RH. Tetralogy of Fallot: a morpho-metric and geometric study. Am J Cardiol. 1975;35:402–412.
10. Anderson RH, Baker EJ, Penny DJ, Redington AN, Rigby ML,Wernovsky G. Paediatric Cardiology. 3rd ed. New York: ChurchillLivingstone; 2010.
Mark #icholls is a freelance medical journalist.
Professor Anderson in Pittsburgh, Penn, 2008, with, from left to right, “my old friend” paediatric cardiologist, Bob Zuberbuhler, MD,from the Children’s Hospital of Pittsburgh, Pittsburgh, who offered him a platform for research at the University of Pittsburgh: Sang Park,MD; Victor Morell, MD; and Steve Webber, MD. A number of people inspired Professor Anderson and had a role in helping shape hiscareer. At the University of Amsterdam, the #etherlands, these people included Dirk Durrer, MD, professor of cardiology and clinicalphysiology; Michiel (Giel) Janse, MD, PhD, emeritus professor of experimental cardiology; and Anton Becker, MD, professor in theDepartment of Cardiovascular Pathology. Other key figures included Elliot Shinebourne, MD, FRCP, consultant paediatric cardiologistat the Royal Brompton Hospital, London, England; Michael Tynan, MD, FRCP, professor in the Department of Paediatric Cardiology,Guys Hospital, London; the late Fergus Macartney, MB, FRCP; and Jane Somerville, MD, FRCP, initially from the #ational HeartHospital and subsequently at the Royal Brompton Hospital. Professor Anderson also reflects on being inspired by meetings with JohnKirklin, MD, from the University of Alabama in Birmingham, Ala; Francis Fontan, MD, from Bordeaux, France; and Lucio Parenzan,MD, from Bergamo, Italy. Photograph courtesy of Professor Anderson.
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The introduction of rotary blood pumps ushered in a newera in the field of mechanical circulatory support, and
Georg M. Wieselthaler, MD, associate professor of surgeryand medical director for mechanical circulatory support inthe Department of Cardiothoracic Surgery, MedicalUniversity of Vienna, Vienna, Austria, was an early inves-tigator of this new technology. Surgeons were using pumpsthat produced pulsatile blood flow, and it was believed thatthis was needed in the long term. The new pumps produceda pathophysiological situation of nonpulsatile flow.The race in 1998 to implant the first miniaturised axial
flow pump was between Vienna and the German HeartCentre in Berlin, Germany. The pump’s inventor, MichaelDeBakey, MD, of Baylor College of Medicine in Houston,Tex, asked both centres to identify patients, settle any reg-ulatory issues, and let him know when they were ready.Professor DeBakey was therefore in Berlin when ProfessorRoland Hetzer, MD, PhD, medical director and chair of theExecutive Management Board Deutsches Herzzentrum,Berlin, implanted the first 2 patients in the world, but nei-ther survived. He was also present when 2 patients weresubsequently implanted in Vienna in 1998 by ProfessorErnst Wolner, Professor George Noon, and ProfessorWieselthaler, and these patients became the first 2 long-term survivors of the new technology and its consequentpulseless pattern of blood flow.
Patients Have Been Supported for 8 Years on PumpsProfessor Wieselthaler and his colleagues summarised theexperiences of the Department of Cardiothoracic Surgeryat the Medical University of Vienna with the new pump inan article in Circulation in 2000.1 It produced some unusualsituations. When the first patient, a 65-year-old man, waswalking around the hospital with his wife after 1 monthwith the pump, he became tired and lay down on the floorfor a rest. The emergency staff rushed towards him, couldnot find a pulse, and tried to resuscitate him. ProfessorWieselthaler was called and had to explain that the patientwas fine despite having no pulse.Professor Wieselthaler was awarded the Medforte–Olsen
Clinical Award from the International Society for RotaryBlood Pumps (ISRBP) in 1999 at the 7th ISRBP confer-ence in Tokyo for his work on the clinical application ofrotary blood pumps, and again in 2001 for his work on
Georg M. Wieselthaler, associate professor of surgery and medical director formechanical circulatory support, Department of Cardiothoracic Surgery, MedicalUniversity of Vienna, Vienna, Austria, and vice president of the InternationalSociety for Rotary Blood Pumps talks to Jennifer Taylor, BSc, MSc, MPhil.
Spotlight: Georg M. Wieselthaler, MDPioneering Work on Heart Pumps and Circulatory Support
The Viennese team—Professor Wolner, Professor #oon, andProfessor Wieselthaler—implanting 1 of their first 2 patients, withthe miniaturised axial flow pump in #ovember 1998 watched bythe pump’s inventor Professor DeBakey (centre behind drape).Both patients survived and were transplanted, though 1 has sincedied of cancer. Photograph courtesy of Professor Wieselthaler.
Professor Wieselthaler’s experience operating on animals and asan electrical engineer meant that he was well suited for the heartpump field. His father was a veterinarian, and as a boy, he helpedhis father operate on domestic pets, as well as boa constrictors,pythons, and crocodiles from a nearby snake farm. Here he assistshis father in an operation on a 6-metre long python. After graduat-ing in electrical engineering in 1978 Professor Wieselthaler wasuninspired by his first job, so he decided to pursue medicineinstead, graduating from the University of Vienna in 1987.Photograph courtesy of Professor Wieselthaler.
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physical rehabilitation training and spiroergometry ofpatients with the pump.2,3 The award is named after veteri-narian Donald Olsen, a major mentor of the mechanicalcirculatory support community and an early collaborator ofWillem Kolff, MD, and Robert Jarvik, MD. He partici-pated in the first long-term totalartificial heart implantation in DrBarney Clark in 1982 in SaltLake City, Utah.Professor Wieselthaler’s stud-
ies with his colleagues on the hor-monal regulation of patients onlong-term nonpulsatile supportshowed that endocrine functionwas not impaired compared withage- and-sex matched controls,4and they also confirmed thatnonpulsatile flow is not deleteri-ous in the long term. Today theyknow that the flow is not com-pletely nonpulsatile; rather it is alow pulsatile flow with a low-pulse pressure amplitude, andsome of their patients have been supported for up to 8 yearson these pumps.
Production and Implantation of a Total ArtificialHeart in 1986Vienna has a long tradition of using circulatory supportsystems, and the chair of the department, Professor ErnstWolner, MD, was the first person to insert an intraaorticballoon pump into a human in Europe in 1968. Duringmedical school, a programme on the total artificial heart
was relaunched, and Professor Wieselthaler was given ajob as a calf sitter in the animal lab of the surgery depart-ment in 1984. Pumps were implanted into calves, and thecalf sitters were doctors for the animals and took care of themachines. It was then that the department discovered that
Wieselthaler not only had experi-ence with animals but was also anelectrical engineer.Professor Wieselthaler then
moved to the engineering lab,where he met his long-term colla-borator, Professor Heinrich Schima,PhD, an engineer. Together theyworked on the driving unit of thetotal artificial heart. He says, “Inthose days, we believed that if youhad a patient with end-stage heartfailure, you had to cut out the fail-ing heart and replace it with a totalartificial heart, both ventricles, bothsides, and that was the solution.”
The first implant of the total artificial heart they devel-oped was carried out in Vienna in June 1986. It was abridging procedure to transplantation with a donor heart,and they aimed to keep the bridging time short—between10 and 20 days. The procedure began a series of discus-sions between himself and Professor Schima about howthe pump could be made smaller. They concluded thatthere was no way to make pulsatile pumps, and especial-ly the bulky driving units, significantly smaller, but thatrotary blood pumps were an alternative that should beinvestigated.
Professor Wieselthaler and the mechanical circulatory support team of the Department of Cardiothoracic Surgery at the MedicalUniversity of Vienna, Vienna, Austria, with 5 patients who have been treated with ventricular assist devices and who remain in close con-tact with the team. Photograph courtesy of Professor Wieselthaler.
1998 photograph of a centrifugal heart pump.Photograph courtesy of Professor Wieselthaler.
June 15, 2010, pp. f133-f138forpress28.5.10:Cir Euro Template 1 28/05/2010 17:31 Page 5
Editor: Christoph Bode, MD, FESC, FACC, FAHAManaging Editor: Lindy van den Berghe, BMedSci, BM, BSWe welcome comments. E-mail [email protected]
The opinions expressed in Circulation: European Perspectivesin Cardiology are not necessarily those of the editors or ofthe American Heart Association.
A Seminal Meeting on Heart PumpsWithout the Internet, it was difficult to pull together theknowledge about nonpulsatile pumps, so the young fellowsorganised an international meeting on rotary blood pumpsin 1988. The 3-day meeting was held at a ski resort in theAustrian mountains in early December. It was the onlyhotel open, and the heavy 1.5-metre snowfall meant no onecould leave the building. The meeting attracted groupsfrom across Europe and the United States, as well as the bigpersonalities in the field, including Professor Olsen, MD,Yuki Nose, MD, PhD, and Professor Noon. The meetingchanged the direction of their research dramatically, andthey switched from the development of pulsatile pumps tothe development of rotary blood pumps. They began work-ing on a miniaturised centrifugal pump and got as far aslong-term animal experiments until they ran out of finan-cial support from the university.5 They were able to sell themotor of the miniaturised pump to Baylor College, and it isnow being used in a pump available in Japan. The meetingwas so successful that there was a follow-up meeting in1991, also inAustria, and in 1992, the International Societyfor Rotary Blood Pumps was founded. ProfessorWieselthaler is vice-president of the International Societyfor Rotary Blood Pumps and will be president in 2 years.He says, “The society arose out of the spirit that was cre-ated out of these 2 meetings we had here in Austria.”Rotary pumps are high sheer stress machines that can
interfere with von Willebrand’s factor. The factor is cleavedinto smaller parts that circulate in the blood so platelets canno longer be activated, leading to an artificial, acquired vonWillebrand’s disease.6 One of Professor Wieselthaler’sprimary goals is to be an interdisciplinary scientist and cli-nician. He says, “Sometimes you get great ideas to workon, or all of a sudden you get a solution for 1 of the ques-tions you’ve had for quite some time. Therefore, I reallylike that kind of interdisciplinary collaboration.”Another exciting piece of work is a collaboration with a
U.S. company to develop a left ventricular assist device
that is on the market inEurope and being consid-ered by the United States.Professor Wieselthalerbegan working with theFlorida-based start-upcompany in 2003. Agroup of engineers hadbuilt the pump and doneexperiments on animals,but it needed help withclinical application. Hecarried out the firstimplant worldwide of thepump in Vienna in 2006.
Both patients were supported for more than 1 year and thensuccessfully transplanted.Professor Wieselthaler has had a number of visiting fel-
lowships to the United States and Canada to learn howmedicine is practiced in other countries. Today he travelsextensively, and he particularly enjoys collaborating withdifferent disciplines, including engineering, haematology,and haemostaseology. One example is the collaborationwith the Department of Haematology and Haemostaseologyat the Medical University, Munich, Germany, to investigatethe interaction of blood components with mechanicalpumps that leads to anticoagulation and anti-aggregation.
References1. Wieselthaler GM, Schima H, Hiesmayr M, Pacher R, Laufer G, Noon GP,DeBakey M, Wolner E. First clinical experience with the DeBakey VADcontinuous-axial-flow pump for bridge to transplantation. Circulation.2000;101:356–359.
2. Wieselthaler GM, Schima H, Lassnigg AM, Dworschak M, Pacher R,Grimm M, Wolner E. Lessons learned from the first clinical implants ofthe DeBakey ventricular assist device axial pump: a single center report.Ann Thorac Surg. 2001;71(3 Suppl):S139–S143; discussion S144–S146.
3. Wieselthaler GM, Schima H, Dworschak M, Quittan M, Nuhr M, CzernyM, Seebacher G, Huber L, Grimm M, Wolner E. First experiences withoutpatient care of patients with implanted axial flow pumps. ArtifOrgans. 2001;25:331–335.
4. Wieselthaler GM, Riedl M, Schima H, Wagner O, Waldhäusl W, WolnerE, Luger A, Clodi M. Endocrine function is not impaired in patients witha continuous MicroMed-DeBakey axial flow pump. J Thorac CardiovascSurg. 2007;133:2–6.
5. Schima H, Trubel W, Wieselthaler G, Schmidt C, Müller MR, Siegl H,Losert U, Wolner E. The Vienna implantable centrifugal blood pump.Artif Organs. 1994;18:500–505.
6. Steinlechner B, Dworschak M, Birkenberg B, Duris M, Zeidler P, FischerH, Milosevic L, Wieselthaler G, Wolner E, Quehenberger P, Jilma B.Platelet dysfunction in outpatients with left ventricular assist devices.Ann Thorac Surg. 2009;87:131–137.
Contact details for Professor Wieselthaler: MedicalUniversity of Vienna/Vienna General Hospital,Waehringer Guertel 18-20, A-1090 Vienna, Austria.E-mail: [email protected];tel: +43 1 40400 6835; fax: +43 1 40400 6735.
Jennifer Taylor is a freelance medical journalist.
Photographs taken at the seminal 1988 meeting on heart pumps in Austria. Left, Drs Affeld, Olsen, and #osein the seminar room. Right, Enjoying the evening entertainment. Professor Wieselthaler recalls, “This was 1of the most memorable meetings I have ever had. We had great discussions sitting around the fireplace enjoy-ing a glass of wine or a hot tea. It was very fruitful.” Photograph courtesy of Professor Wieselthaler.
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