A Man-Made Heart

Summary

Cardiac Cowboys, Episode 5: "A Man-Made Heart"

Podcast: Cardiac Cowboys (iHeartPodcasts)
Host: Chris Pine
Air Date: September 29, 2025

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Overview

This riveting episode traces the high-stakes race to build and implant the world’s first artificial heart—focusing on the fierce rivalry between two surgical titans, Dr. Michael DeBakey and Dr. Denton Cooley. Against a backdrop of medical innovation, personal ambition, ethical controversy, and betrayal, the episode explores how these maverick doctors and their teams transformed the landscape of heart surgery, setting the stage for life-saving advances and bitter professional fallout.

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Key Discussion Points & Insights

The Donor Heart Dilemma and the Birth of the Artificial Heart (00:35–03:37)

• Problem Statement: There simply aren’t enough donor hearts to save the hundreds of thousands dying from heart failure annually.
• Historical Context: With transplantation limited by donor shortages, Michael DeBakey and Domingo Liotta envision a future where a mechanical heart could take over—a vision fueled by both ambition and desperation.
• Notable Quote:

  "Counting on heart transplantation to cure the woes associated with heart failure is like counting on the lottery to cure poverty."
  —Lynn Warner Stevenson, cited by the narrator (01:25)

Shocking Betrayal: The First Artificial Heart Operation (03:38–06:12)

• Surprise Announcement: While DeBakey prepares to update federal officials, news breaks that Cooley (DeBakey’s protégé) and Liotta have implanted an artificial heart in a human patient—using a design DeBakey claims is his.
• DeBakey’s Perspective:

  "They weren’t even clever enough to make it look different."
  —Michael DeBakey, via Chris Pine (04:35)

• Ethical and Legal Questions: Immediate concern arises about misuse of government funds and lack of regulatory approval, risking reputations and institutional funding.

Roots of Rivalry: DeBakey vs. Cooley (06:12–11:09)

• Rival Surgeons: The personal and professional split between DeBakey and Cooley, cast as “a father-son complex,” becomes a defining feud.

  “We began to have some conflict…Mike and I began a bit of a rivalry. This was a typical father-son complex.”
  —Dr. Denton Cooley, archival (06:36–07:13)

• Cooley’s Ambition: Cooley establishes the Texas Heart Institute, raising vast funds and assembling a surgical “assembly line” to serve more patients, often recruiting from DeBakey’s own team.

Contrasting Leadership and Lives (11:09–15:25)

• Cooley’s Approach: Efficient, affable, and family-oriented, Cooley impresses colleagues and patients alike.

  “There’s not a surgeon today that could do 14 tough cases in a day. Cooley could do it.”
  —Dr. Bud Fraser (10:32)

• DeBakey’s Persona: The “Texas Tornado,” DeBakey is relentless, politically astute, but often absent from family, constantly advancing both his surgical and national policy agendas.

  “He was a notoriously fast driver…Debakey was in a race against time.”
  —Jamie Napoli (12:21–12:39)

The Inventor: Domingo Liotta and the Dream of Mechanized Hearts (15:09–18:31)

• Liotta’s Role: The brilliant, single-minded Argentine surgeon whose early work catalyzes progress toward an artificial heart, only to be overshadowed.

  “He was kind of Frankenstein, what he was doing…everybody thought he was crazy, but he was really ahead of his time.”
  —Patrick Liotta (16:27–16:30)

• The LVAD: As the total artificial heart proves elusive, focus shifts to the left ventricular assist device (LVAD), a temporary pumping solution that represents a major stepping stone.

Triumphs and Heartbreak: Early LVAD Trials (21:51–28:46)

• First Attempts: The first two patients to receive DeBakey/Liotta’s LVAD die soon after implantation, despite intense media attention and public scrutiny.

  "Dr. Debakey, the object of your heart booster implant was to prolong the patient's life...Why do you say that the operation was a success?"
  "The operation was a success on the basis of the fact that the pump did the job we wanted it to do. The patient's death was due to causes beyond our control."
  —DeBakey, Interview (25:38–26:04)

• Success at Last: Esperanza Del Valle Vazquez survives—marking the first successful LVAD implant. Yet Liotta remains unrecognized in public accounts.

The Ultimate Rift: Cooley, Liotta, and the Secret Artificial Heart Experiment (31:01–36:12)

• Liotta’s Frustration: Shut out by DeBakey, Liotta secretly begins a new partnership with Cooley, quietly moving forward on a total artificial heart.

  "The time had come to really give it a test. And the only real test would be to apply it to a dying patient."
  —Denton Cooley (31:38–31:48)

• Test Subject: Haskell Karp, terminally ill and out of options, consents to the radically experimental procedure.

  "It takes a strong person to try to help themselves."
  —Shirley Karp, Haskell’s wife (36:45)

The First Human Implantation of a Total Artificial Heart (37:12–44:16)

• Groundbreaking Surgery: On April 4, 1969, under intense pressure and with the world watching, Cooley and Liotta remove Karp's failing heart and implant the mechanical device. Karp survives long enough to receive a donor transplant, but ultimately dies from complications.

  “All of a sudden, into the room came a big device…here came in something new, and out came the heart.”
  —Dr. Kenneth Maddox, surgeon (38:42)

• Media Blitz: Cooley and Liotta become instant celebrities, while DeBakey is blindsided and enraged by the unauthorized use of his team’s research.

Fallout: Professional and Legal Consequences (44:16–54:46)

• Institutional Backlash: Cooley is censured by medical authorities for violating government research guidelines and resigns from Baylor.
• Personal Vendetta: DeBakey launches what Cooley calls a “personal attack,” and the feud polarizes the Houston surgical community.

  "It was a personal attack. It was an all out war…They both were playing a little bit dirty pool."
  —Dr. Don Wukash (49:00–49:07)

• Lawsuit: Shirley Karp sues Cooley and Liotta for lack of informed consent, with DeBakey called as a potential key witness. In a surprising turn, DeBakey refuses to testify against Cooley, effectively ending the case in Cooley’s favor.

Legacy and Aftermath (54:46–57:19)

• Enduring Impact: The dream of a true total artificial heart remains out of reach, but LVADs are now saving thousands of lives.

  “Today, the dream of a fully implanted, permanent, total artificial heart remains just beyond the horizon. The lvad, on the other hand, has become a common life saving measure for patients suffering from heart failure.”
  —Jamie Napoli (55:32)

• A Bitter Feud: Though only a few blocks apart, DeBakey and Cooley don’t speak for nearly 40 years, their split infamous in medical history.

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Notable Quotes & Memorable Moments

• "Counting on heart transplantation to cure the woes associated with heart failure is like counting on the lottery to cure poverty."
  —Lynn Warner Stevenson (01:25)

• "They weren’t even clever enough to make it look different."
  —Michael DeBakey (via Life magazine, 04:35)

• “There’s not a surgeon today that could do 14 tough cases in a day. Cooley could do it.”
  —Dr. Bud Fraser (10:32)

• "He was kind of Frankenstein, what he was doing…everybody thought he was crazy, but he was really ahead of his time."
  —Patrick Liotta (16:27)

• "Well, in those days, I didn't feel like we needed permission...if I had sought permission...I probably would have been denied and we'd have lost a golden opportunity."
  —Denton Cooley, on taking the risk (35:56–36:12)

• "It was a personal attack. It was an all out war."
  —Dr. Don Wukash (49:00)

• "I believe that we as surgeons have an implied contract with our patients...if it means taking a risk with his reputation, I think that he would be neglectful of his duty if he withdrew from that risk."
  —Denton Cooley (52:55)

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Structured Timeline of Key Segments

| Timestamp | Section/Event | |---------------|------------------| | 00:35–03:37 | Laying out the heart failure crisis and early artificial heart ambitions | | 03:38–06:12 | Cooley’s surprise announcement and DeBakey’s reaction | | 06:12–11:09 | Rivalry origins, founding of Texas Heart Institute, contrasting working styles | | 15:09–18:31 | Domingo Liotta’s backstory and early artificial heart prototyping | | 21:51–28:46 | Early LVAD implants, deaths, and first survivor | | 31:01–36:12 | Liotta’s partnership with Cooley and secret development of the total artificial heart | | 37:12–44:16 | The first artificial heart implantation in Haskell Karp | | 44:16–54:46 | Institutional censures, lawsuit, and DeBakey’s surprising restraint | | 54:46–57:19 | Aftermath, the rise of LVADs, and the lingering DeBakey-Cooley feud |

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Conclusion

This episode distills a defining moment in medical history: a technological, ethical, and personal drama that shaped the future of cardiac care. Through vivid storytelling, archival recordings, and candid interviews, it documents the innovation and human cost behind making a "man-made heart"—and the legendary feud that nearly tore it all apart.

Next Episode Preview:
The series continues with the tailspin of Walt Lillehei and possible reconciliation efforts in Houston.

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Useful For:
Anyone interested in medical innovation, the personalities who drive progress (and conflict), and the tangled web of ethics, ambition, and technology behind some of the most profound life-saving devices of the modern era.

Transcript

[Narrator/Interviewer]

This is an iHeart podcast.

[Jasper AI Advertiser]

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[Chris Pine]

Welcome to the Wild west of American Medicine. I'm Chris Pine and this is Cardiac the gripping true story behind the birth of open heart surgery and the maverick surgeons who made it happen when the race to perform a human heart transplant kicked off at the Beginning of the 1960s, Baylor surgical chief Michael DeBakey was one of the first surgeons to recognize its limitations. Even if doctors can solve the issue of organ rejection and rewrite the definition of death, one glaring problem remains. There simply aren't enough donor hearts to go around.

[Narrator/Interviewer]

There are 400,000Americans that die of heart failure a year. Expanding the pool is a drop in the bucket.

[Chris Pine]

That's cardiovascular surgeon Dr. Billy Cohn.

[Narrator/Interviewer]

Lynn Warner Stevenson, a famous cardiologist, says counting on heart transplantation to cure the woes associated with heart failure is like counting on the lottery to cure poverty.

[Chris Pine]

So rather than competing with the likes of Christian Barnard and Norm Shumway, debakey set his sights further into the future. A future in which a failing human heart can be replaced with something else entirely. For the last eight years, DeBakey and his team have been building the world's first man made heart. Back in 1961, DeBakey recruited a brilliant Argentine surgeon named Domingo Liotta to spearhead an artificial heart program at Baylor. The two men have spent the better part of a decade working together toward a breakthrough that could potentially save hundreds of thousands of lives every year. Thanks to DeBakey's extensive lobbying, Liotta's research has been funded with millions of dollars in government grants. And that's what brings DeBakey on April 4, 1969, to Washington, D.C. deBakey checks into the Hay Adams, a luxury hotel that overlooks the White House. Tomorrow he's due at the National Heart Institute in Bethesda, Maryland, to give an update on his and Domingo Liotta's progress. He's preparing his notes when a call comes in from Houston. The news he hears doesn't make much sense. DeBakey's former protege Denton Cooley has just saved a dying man's life by implanting an artificial heart into his chest. But Cooley doesn't have an artificial heart program. As far as DeBakey knows, Cooley was never much interested in the idea. So how can he already have a working artificial heart of his own? At St. Luke's Episcopal Hospital in Houston, a press conference is taking place.

[Narrator/Interviewer]

What we have done is to replace the human heart with with a completely mechanical device. The replacement is a total one. The heart has been removed and the replacement is done in the cavity in which the heart usually lies.

[Chris Pine]

Black and white television screens all over the world flicker with the smiling, handsome face of 48 year old Denton Cooley.

[Narrator/Interviewer]

How long do you think you can.

[Jamie Napoli]

Keep the device working in the body?

[Narrator/Interviewer]

I see no reason why it wouldn't function for periods of a month or more. But at the present time, we can look for a week or 10 days. That would satisfy my highest hopes.

[Chris Pine]

Sitting beside Cooley in his white lab coat is Dr. Domingo Liotta, Debakey's artificial heart expert from Argentina. Cooley is claiming the two of them developed this device together. But how could that be? Leota was hired by DeBakey and his research was paid for with DeBakey's grants. And then DeBakey sees a photograph of Cooley and Liotta's invention and he's stunned. Now he understands. They use the exact same heart. DeBakey will later say to Life magazine they weren't even clever enough to make it look different. Michael DeBakey feels betrayed. He believes his work and funding have been stolen by surgeons who whose careers he made by Denton Cooley of all people. The man who once showed up at his doorstep to berate him for attempting to repair a child's heart defect using Cooley's coffee pot bubble oxygenator. Worst of all, if it turns out that Cooley and Liotta's device was Indeed funded with DeBakey's grant money, this operation violated the government's guidelines for human experimentation. It won't just be devastating to Cooley and Liotta's careers, it could tear down DeBakey too. Along with the empire he's built at Baylor. From OSO Studios, this is Cardiac Cowboys, a podcast about life, death and innovation in the American Heartland. Episode 5AMan Made Heart here's writer and executive producer Jamie Napoli.

[Jamie Napoli]

Back in the 1950s, Michael DeBakey and Denton Cooley were building their larger than life reputations one surgery at a time. Thanks to the unparalleled speed and precision of his surgical work, Cooley was rapidly outpacing DeBakey's heart program. Between the two surgeons, a competition was born.

[Narrator/Interviewer]

Sooner or later, we began to have some conflict.

[Jamie Napoli]

That's an archival recording of Danton Cooley.

[Narrator/Interviewer]

Dr. DeBakey might hear that I removed an aortic aneurysm. That probably upset him to some extent because I hadn't called upon him for advice in those early days. But one thing after another, Mike and I began a bit of a rivalry. This was a typical father son complex.

[Jamie Napoli]

That's cardiothoracic surgeon Dr. Don Wukash, who worked with both Cooley and DeBakey.

[Narrator/Interviewer]

That Huli got to be around the midlife crisis, around 40 years. He wants to have a little separation and a little self identity. And if the father figure is unable to let go of control and the son character is willing to fight for this independence, you have this break.

[Jamie Napoli]

While Cooley remained a faculty member at Baylor, he moved his clinical practice to the nearby St. Luke's Episcopal Hospital and Texas Children's Hospital. He was growing increasingly frustrated with his old mentor. He often felt unappreciated and left out of the spotlight. And he didn't approve of DeBakey's style of leadership.

[Narrator/Interviewer]

I felt that he was too abusive of all of his residents, medical students and so forth. And I didn't think I could to be permanently involved in that environment.

[Jamie Napoli]

On July 13, 1962, Cooley showed up to a joint meeting of the St. Luke's Episcopal and Texas Children's hospital boards with a radical proposal. Here's Denton Cooley's daughter, Dr. Louise Cooley Davis.

[Narrator/Interviewer]

My father said, I am the best.

[Jamie Napoli]

Pediatric heart surgeon, and I would like.

[Jasper AI Advertiser]

To start my own program.

[Jamie Napoli]

A new hospital practically across the street from DeBakey's Baylor College of Medicine, exclusively dedicated to cardiovascular health. For branding purposes, Cooley gave it a simple, memorable name, the Texas Heart Institute. Though his initial budget was around $4.5 million, the hospital would end up costing over 10 times that. He did that with his own monies, with his own donations, with his patients. Donating several Houston philanthropists.

[Narrator/Interviewer]

Donating.

[Jamie Napoli]

One of Cooley's largest donors was the chairman of the Jim Beam whiskey distillery, Harry S. Blum. After repairing the wealthy businessman's ruptured aneurysm, Cooley pulled a fundraising trick he must have learned from DeBakey. He refused to present a bill for his services, saying, I can't put a price on your life. Overwhelmed by the gesture, Blum donated $1 million toward the creation of the Texas Heart Institute, Cooley assembled an elite surgical team, many of whom were so called refugees from DeBakey's service. And while Cooley was beloved by his staff for his affable personality and joke telling, his ORs were ruthlessly efficient. He turned cardiac surgery into something like an assembly line procedure.

[Narrator/Interviewer]

His team would open the chest, prep the bypass, then my father would walk.

[Jamie Napoli]

In and he would actually start the surgery. And he had five rooms going at one time and I think 10 associates.

[Narrator/Interviewer]

Who were doing the same thing so they could take care of 35 patients a day. My father never wanted to turn anybody away.

[Jamie Napoli]

If they needed surgery, he wanted to find a way to do it.

[Narrator/Interviewer]

There's not a pilot a day that could take that spirit of St. Louis and fly across the Atlantic. And there's not a surgeon today that could do 14 tough cases in a day. Cooley could do it.

[Jamie Napoli]

That's cardiac surgeon Dr. Bud Fraser.

[Narrator/Interviewer]

He was so fast. And I've got his copies of his operative reports. They're all in seconds. 7 minutes, 15 seconds, 8 minutes, 22 seconds. I never saw a one that they were on the heart lung machine more than 20 minutes. He was just smooth the silk. He's the best technical surgeon I'll ever live.

[Jamie Napoli]

Cooley performed so many heart operations, the nearby Shamrock Hilton Hotel, which was constantly packed with his patients and their families, came to be known as the Cooley Hilton. And while many of his colleagues struggled to maintain anything resembling a work life balance, Cooley always made sure to set aside time for his family.

[Narrator/Interviewer]

Saturday mornings, we'd zip off to our family farm called Kul Acres, and he played tennis with us all day. We'd play baseball, we'd ride horses, and.

[Jasper AI Advertiser]

Then Sunday at 3 o' clock, we'd.

[Narrator/Interviewer]

All pile into the station wagon because he had to go to the hospital.

[Jamie Napoli]

At five o' clock to make rounds.

[Narrator/Interviewer]

I never really felt like he was.

[Jamie Napoli]

A surgeon when I was with him. He was my dad. For Michael DeBakey, on the other hand, finding time for his wife and sons was more difficult to manage. There was hardly enough time in the day for sleeping or commuting to work.

[Narrator/Interviewer]

He was a notoriously fast driver.

[Jamie Napoli]

As a young cardiothoracic surgeon at Baylor, Dr. Gerald Laurie would occasionally ride with DeBakey between hospitals.

[Narrator/Interviewer]

He'd feel the suspension bottom out, and then we'd come out of there like the deuce of hazard. I mean, literally all four wheels in the.

[Jamie Napoli]

Debakey was in a race against time. Obsessively devoted to the care of his patients not even totaling his Maserati, could slow the man down.

[Narrator/Interviewer]

One morning I noticed he had a little glitter in his hair, like a bunch of little sparkles. Trying to work out what this was. And someone came and said, Dr. Beekee, the police are here. He had this Maserati and he tried to turn from the center of the road into the left lane to get into the hospital. And unfortunately he'd been T boned. This was the shattered windscreen that was in his hair. And he just got out and said, you know, I'm busy, you know where to find me, and come in and started making rounds with us. So that was kind of the atmosphere at that time.

[Jamie Napoli]

Unlike Denton Cooley, DeBakey's work wasn't limited to ORS and hospital boardrooms in Washington, D.C. he helped establish the National Library of Medicine. He chaired the President's commission on Heart Disease, Cancer and Stroke. And he publicly endorsed Medicare when it was deeply unpopular.

[Narrator/Interviewer]

President Kennedy wanted to have a television conference in the Rose Garden with some doctors showing they supported Medicare and asked me if I would join.

[Jamie Napoli]

That's an archival recording of Michael DeBakey.

[Narrator/Interviewer]

Well, I was the only one up there. When I got home, I had a stack of telegrams from doctors all over the country calling me a traitor. And some of them saying, they never refer a patient to me. How else are you going to take care of these poor people? Dr. Debakey was frantically busy with many, many things. He was flying to Washington periodically to consult with various presidents. Monday morning we'd be talking and he mentioned he'd been up at the White House for a meeting over the weekend.

[Jamie Napoli]

Early on in his career, DeBakey had learned the value of self promotion. The more his reputation grew, the more power he had to affect change around the world.

[Narrator/Interviewer]

Surgeon to the royalty of Europe and the royalty of Hollywood. Michael E. DeBake Hill, Master Surgeon, but also a politician. Also a man who stormed through a 20 hour day. A man they call the Texas Tornado.

[Jamie Napoli]

The man they called the Texas Tornado always made time for celebrity patients. And he never hesitated to drop their names in presentations and interviews.

[Narrator/Interviewer]

Marlene Dietrich was referred to me and she gave me an autograph of herself. I didn't ask for it. I had gotten to know Frank Sinatra quite well because I took care of his father. He said, I'm giving a party for Jack Benning's 80th birthday.

[Jamie Napoli]

In the early 1960s, DeBakey turned his focus to a device that promised to revolutionize cardiac medicine.

[Narrator/Interviewer]

With all the fantastic things that you can do. Today, what is it you can't do and what is it you would like to do? We should be able to develop a mechanical pump that will substitute for the heart. And I'm convinced this can be done.

[Jamie Napoli]

DeBakey had a vision. But it would take a singularly brilliant and dogged inventor to actually build such a device. At the National University of Cordoba in Argentina, a young surgeon was hard at work. As early as the 1950s, Domingo Liotta, working alongside his older brother Salvador, had been developing prototypes of the first artificial heart.

[Narrator/Interviewer]

He was kind of Frankenstein, what he was doing.

[Jamie Napoli]

Patrick Liotta is Domingo's youngest son.

[Narrator/Interviewer]

Everybody thought he was crazy, but he was really ahead of his time.

[Jamie Napoli]

The idea was crazy. Nearly a decade before Christian Barnard transplanted a human heart for the first time, Domingo Liotta was working to replace the organ with a small implantable pump. In 1961, Liotta's radical experiments earned him an invitation to the Cleveland Clinic. And it was there that he caught the attention of Michael DeBakey.

[Narrator/Interviewer]

Michael invited him to work for one year, one year as a fellowship in Texas. And he always said that was the most important letter he ever had in his life. That letter makes him feel that he was on the right path, doing the right things.

[Jamie Napoli]

Liotta stayed at Baylor for much longer than his initial one year fellowship. His family settled into Houston society. His kids were enrolled in American private schools. And Domingo Liotta was doing the most consequential work of his career. A total artificial heart felt within reach. Here's cardiac surgeon Dr. Bud Fraser again.

[Narrator/Interviewer]

I remember talking to Dr. DeBakey about 1964, and he told me, by 1980, there'll be 100,000Americans with an artificial heart.

[Jamie Napoli]

DeBakey threw the full weight of his political influence into obtaining government grants. In 1965, he convinced Congress to allocate $40 million to develop an artificial heart. 4.5 million of those funds would go to DeBakey's program. But with the surge in funding came expectations. DeBakey felt an urgent pressure to deliver results. And as much as he loved to herald the arrival of the total artificial heart, in reality it was still years away from human application. DeBakey needed something achievable in the short term.

[Narrator/Interviewer]

The total artificial heart was, you know, a complicated process.

[Jamie Napoli]

That's Michael DeBakey again.

[Narrator/Interviewer]

They were much simpler to work on LVAD, because that was just one ventricle.

[Jamie Napoli]

The LVAD, or left ventricular Assist device, was developed by Domingo Liotta as a stepping stone to a total artificial heart. It was a grapefruit sized pump that could be implanted in a patient's chest so long as the patient remained tethered to a compressed air machine. The LVAD would boost the beating of their left ventricle, the pumping lower left chamber of their heart. And while it may have been a stretch to call the LVAD an artificial heart, Michael DeBakey hadn't become the Texas Tornado by splitting hairs. In January of 1969, at the 50th anniversary dinner of the New York Heart Association, DeBakey showed off a model of the device to the audience and announced that this artificial heart would be ready for human use within a month. A week later, DeBakey gave the device to President Lyndon Johnson, who then presented it to Congressman John E. Fogarty in recognition of his work to allocate funding for artificial heart research. A few weeks after that, DeBakey again touted the LVAD when he appeared on Walter Cronkite's the 20th Century series.

[Narrator/Interviewer]

Dr. Michael Ellis DeBakey, the world renowned Houston specialist Man of the Month American.

[Jamie Napoli]

Heart Month so it came as it was no surprise when photographers and journalists arrived at Methodist Hospital in droves waiting to capture the successful implantation of the world's first artificial heart. DeBakey stoked the flames of the media frenzy when he delivered a two hour press conference to introduce the implant team and concluded the team is ready. They were just waiting on the ideal recipient.

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[Jamie Napoli]

65 year old retired coal miner Marcel DeRudder had suffered from heart problems for decades. In the spring of 1966, DeBakey planned to replace Marcel's diseased mitral valve with a prosthetic one. The problem was that Marcel's heart had deteriorated to such an extent that it might not be capable of beating on its own. After the operation, DeBakey presented the dying patient with an option of last resort. If Marcel's heart could not be revived, DeBakey wanted to test out the LVAD.

[Narrator/Interviewer]

I explained to him that we felt quite confident about it on the basis of our experimental work and that I thought that it would be of additional value in reducing the risk of the operation.

[Jamie Napoli]

Marcel knew that there was a strong possibility he would not survive. He told his wife, Edna, that he was willing to serve as a guinea pig so that DeBakey might learn something that would save someone else. On April 21, 1966, two days after DeBakey's press conference, Marcel Deruder was wheeled into an OR at Methodist Hospital. Bakey had arranged for the entire operation to be filmed for from overhead and documented in close up by a still photographer, none other than Life magazine's Ralph Morris, the official photographer of the Mercury astronauts. DeBakey implanted the prosthetic valve and shut off the heart lung machine. But in its weakened state, Marcel de Ruder's heart refused to regain its rhythm. Just as DeBakey had anticipated, the LVAD had become Marcel's only shot at survival. DeBakey sheared one of Marcel's ribs to make room for the device, and then he began sewing the LVAD into place. Two hours into the operation, Marcel's heart once again started to beat. After a few panic filled stops and starts, Marcel was on track for recovery. DeBakey left the OR and headed straight for a press conference.

[Narrator/Interviewer]

They asked if it is an extremely difficult operation or can it be done by surgeons around the world. Oh, certainly this is not a difficult operation for any team that that is experienced in cardiovascular surgery. They they can.

[Jamie Napoli]

Papers all across the country ran headlines like Artificial Heart Patient Doing well and Artificial Heart Beats on. Despite the fact that the heart Marcel Deruder was born with was still beating inside his chest, rarely did the news coverage mention the name Domingo Liotta. 24 hours after the LVAD implantation, Marcel Deruder still had not regained consciousness. With every hour that passed, it grew likelier that he'd suffered brain damage. During the operation, DeBakey resumed his grueling daily routine. But he spent his nights on a cot in the ICU to Keep close watch of his star patient. Four days later, after his left lung ruptured, Marcel Deruder died.

[Narrator/Interviewer]

Dr. Debakey, the object of your heart booster implant was to prolong the patient's life since the patient died. Why do you say that the operation was a success? Well, Mr. Lebok, the operation was a success on the basis of the fact that the pump did the job we wanted it to do. The patient's death was due to causes beyond our control.

[Jamie Napoli]

The response from the medical community was swift and brutal. DeBakey's peers condemned him for publicizing an untested procedure and for giving false hope to patients dying from heart ailments. In a personal letter to DeBakey, Dr. Eugene Bricker of Washington University in St. Louis characterized his old colleague's behavior as unethical and a discredit to the profession of surgery. At Maimonides hospital in Brooklyn, Dr. Adrian Cantrowitz announced that he'd implanted a similar device two months prior, but had refrained from publicizing the operation until he could be certain of its long term success. We do things differently in Brooklyn, Cantrowitz said to reporters. I did everything possible to keep this out of the newspapers. DeBakey took issue with this criticism. He felt the American public had a right to know how $4.5 million of their tax money was being spent. But he'd learned his lesson when he attempted another LVAD implantation less than a month later. He made no big announcements and held no press conferences. The patient died within three days. DeBakey again shut out the press when the opportunity arose for yet another attempt. Esperanza Del Valle Vazquez, a 37 year old beautician from Mexico, had suffered from lifelong rheumatic heart disease. The condition had wreaked havoc on the valves of her heart.

[Narrator/Interviewer]

She had involvement of her aortic valve and her mitral valve. She needed two valves. It was very uncommon to get someone through a two valve replacement.

[Jamie Napoli]

That's Dr. Billy Cohn again. On August 8, 1966, DeBakey brought Esperanza into surgery.

[Narrator/Interviewer]

Dr. DeBakey said, Ring the LVAD in. Let's try. It lowered the pressure in her left atrium so her lungs weren't being beat by pressure and the flow through her body was dramatically increased.

[Jamie Napoli]

Esperanza's heart recovered to such an extent that after 10 days with the device, DeBakey decided he could safely remove the LVAD.

[Narrator/Interviewer]

He took the device out at bedside. He pulled it out just a little bit without pulling it out of the heart. You're gonna feel a little pinched, Dale, you know, clamped it, cut it, sewed it off and let it drop back in and close the skin over it.

[Jamie Napoli]

After a month spent recovering in the icu, Esperanza was discharged and returned home to her family in Mexico City, the first survivor of an LVAD implant. As the LVAD made headlines around the world, its creator, Domingo Liotta felt left in the dust.

[Narrator/Interviewer]

They excluded his name from a lot of these presentations. Sometimes debakey went by himself to these congresses and presented like it was his idea.

[Jamie Napoli]

That's Domingo Liotta's son, Patrick Liotta. Again, DeBakey was the, he was the.

[Narrator/Interviewer]

Guy who can get the money and he was the guy who wanted the credits too.

[Jamie Napoli]

As for Liotta's dream of implanting a total artificial heart, he felt it slipping through his fingers. After the success of the LVAD, it seemed to him that DeBakey had lost interest in the total artificial heart entirely. And Liotta would do anything to see his dream brought to life.

[Jasper AI Advertiser]

This show is about modern mavericks, risk takers, builders and rule breakers pushing new frontiers. At Jasper, we know that spirit. We're doing for marketing what these cardiac cowboys did for medicine. Throwing out the old playbook and building something radically better. Jasper is the agentic content automation platform that helps marketing teams move fast and stay in control. Whether you're launching a product, optimizing web content for LLMs, expanding campaigns into new markets, or scaling audience personalization, Jasper gives your team a repeatable, intelligent system for orchestrating content at scale. Unlike generic AI tools, Jasper doesn't just write with structured workflows. Brand safe automation and built in intelligence that understands your voice, audience and goals. Jasper replaces scattered tools and disconnected processes with one seamless content pipeline. It's already helping thousands of teams reduce production time, cut agency costs and publish more content that's actually on brand. If you're a marketing leader looking to transform how your team works or just trying to keep up with the pace of change, check out Jasper AI. That's Jasper AI.

[Narrator/Interviewer]

Dr. Liotta was very depressed because he couldn't even get an appointment with Dr. DeBakey to show him his heart idea.

[Jamie Napoli]

Dr. Don Wukash was working alongside Domingo Liotta in the Baylor animal lab when he witnessed a meeting that changed the course of history.

[Narrator/Interviewer]

I was there one day when Dr. Keeley happened to come by and said, hi Domingo, what all you doing? He said, well, I'm working on this artificial heart.

[Jamie Napoli]

Fearing the squandering of his life's work. Liotta proposed to Cooley a new partnership. Here's Denton Cooley again.

[Narrator/Interviewer]

I thought and agreed with Dr. Liotta. The time had come to really give it a test. And the only real test would be to apply it to a dying patient.

[Jamie Napoli]

December 1968 marked one year since Christian Barnard's historic heart transplant operation. In that short span of time, transplant fever had subsided. Nearly all of Cooley's transplant recipients had died after their bodies rejected the donor hearts. Liotta's total artificial heart, which was made from synthetic materials and therefore wouldn't be subject to organ rejection, looked like the breakthrough Cooley had been waiting for.

[Narrator/Interviewer]

That was the beginning of the relationship with Dr. Cooley and Dr. Liotta. Dr. Cooley sort of recruited him away to work on weekends and nights on the artificial Patricia Hart.

[Jamie Napoli]

According to Cooley, he and Liotta began working in secret on an altogether new artificial heart. They started with Liotta's original prototype from Argentina and developed it from there. They hired a Rice University engineer to build a power console for the device, paid for with funds from Cooley's foundation and a few small grants. Beginning In January of 1969, Leota implanted their artificial heart into seven cabs in the Baylor animal lab, the last of which lived for 44 hours. With the device, the two men concluded that their total artificial heart was ready for human use. In a room at St. Luke's Episcopal Hospital, a 47 year old man named Haskell Karp was dying. Haskell had worked as a printing estimator in downtown Chicago until his career was cut short by severe heart disease. He'd suffered a series of heart attacks. He had a pacemaker implanted to combat heart block. And by the spring of 1969, he was unable to do much of anything besides wait for a miracle. After evaluating Haskell Karp's condition, Denton Cooley recommended that he undergo a procedure called a ventriculoplasty to remove the damaged tissue from his heart.

[Narrator/Interviewer]

You go on the heart lung machine, you cut out the scar and replace it with a piece of Dacron polyester fabric that was a size that it used to be before it ballooned out.

[Jamie Napoli]

That's Dr. Billy Cohn again.

[Narrator/Interviewer]

Dr. Cooley said, Listen, Mr. Carr, I could try this operation on you, but I think it's not going to work. Your heart is too severely involved. If I think if I cut away all that scar, your heart's not going to like it.

[Jamie Napoli]

If the operation went south, Cooley's next best option would be to transplant a new heart into Haskell's chest. But finding a donor was proving near impossible.

[Narrator/Interviewer]

We were having a more difficult time getting donors, and here was a man who needed a transplant and needed it badly. And immediately.

[Jamie Napoli]

In Haskell Carp Cooley saw a need for the total artificial heart. His and Liotta's device might buy Haskell a little time, something the dying man desperately needed. Cooley also saw an opportunity. This was his chance to push the field of cardiac surgery forward, to perform a revolutionary new operation. Just like his mentors, Alfred Blalock and Vivian Thomas did when they pioneered the blue baby operation back in 1940. Just like Walt Lillehei did again and again throughout the 1950s. And just like Christian Barnard did a little over a year earlier, making him the most famous man in the world, Denton Cooley was the best technical surgeon alive. If anyone could pull this off, it was him. Cooley was aware that he was inviting the wrath of Michael DeBakey. But he wasn't going to let a little rivalry get the way of changing the world.

[Narrator/Interviewer]

Well, in those days, I didn't feel like we needed permission. And I think if I had sought permission from, say, the federal agency or the hospital or something, I think I probably would have been denied and we'd have lost a golden opportunity, as his.

[Jamie Napoli]

Old friend Walt Lilleheid liked to say. Ready. Fire. Aim. On April 3, 1969, Cooley met with Haskell Karp and his wife Shirley to talk over the plan. He brought with him a rabbi to consult with the couple and a consent form. Here's Shirley Karp explaining the choice her husband faced that day.

[Narrator/Interviewer]

It's so personal. You can't advise anybody.

[Jamie Napoli]

And you can?

[Narrator/Interviewer]

I can't take advice from anybody in a situation such as this. I understood what this decision meant to him, and because of that, I agreed with him. It takes a strong person to try to help themselves.

[Jamie Napoli]

The following afternoon, as debakey's plane took off from the Houston Hobby Airport headed for Washington, D.C. haskell Karp was wheeled into surgery. He was pale, sweating profusely, and gasping for air. His anesthesiologist felt that Haskell would die right there in the hallway were it not for immediate surgical intervention. Cooley rushed to the OR and prepped for surgery. It was his fifth heart operation of the day. He opened Haskell's chest to find a severely scarred organ beating within. He said he'd never seen a worse looking heart. Though it was unlikely to work, Cooley dutifully attempted the ventriculoplasty, removing a whopping 35% of Haskell left ventricle. But the heart was beyond saving. Cooley's attempts to shock and massage it back into rhythm were in vain.

[Narrator/Interviewer]

At the end of the operation, the heart didn't have much muscle left, and he would not come off the pump. So this is a room full of people, and you're looking to say, how's Cooley going to get out of this one?

[Jamie Napoli]

Trauma and cardiovascular surgeon Dr. Kenneth Maddox was in the room during the Haskell Carp operation.

[Narrator/Interviewer]

All of a sudden, into the room came a big device. Now, this device turned out to be this artificial heart that had been developed by Domenico Leiota. At the time, we didn't know that history. We just knew that here came in something new, and out came the heart.

[Jamie Napoli]

Cooley began attaching the device to the blood vessels in Haskell's chest. Pushing a needle through silicone tubing is much harder than suturing human tissue, even for the great Denton Cooley. And yet the entire procedure took only about two hours. They switched on the power console, and then Cooley and Liotta watched in intense silence as their total artificial heart began to work. Just as much a showman as his former mentor, Michael DeBakey, Cooley reported on his success in a press conference that night. The AM news station was on in the kitchen radio, and next thing I knew is that I heard them. I heard them say my dad's name. Marty Karp was just 11 years old at the time of his father's operation. I felt the blood just drain from my body.

[Narrator/Interviewer]

It was just surreal.

[Jamie Napoli]

And then I heard the words artificial heart. It was like being in the middle of a science fiction movie.

[Narrator/Interviewer]

At the present time, we can look for a week or 10 days. That would satisfy my highest hopes. We can't find a donor in that period of time. Hopefully, the device will carry on for a longer period of time.

[Jamie Napoli]

When the press conference was over, Denton Cooley took the unorthodox step of welcoming a camera crew into the room where Haskell Carp was recovering.

[Narrator/Interviewer]

Can we get something for you? Wet sponge. Can you say it again? Wet sponge. You want a wet sponge? You'd like a drink? Could you turn the other way so we can get your picture? Speak louder. What can we get for you? Wet sponge. You thirsty? Could you open your eyes for us? Let's look at the color of your eyes. Open real wide. Look up above your head for us. That's it. You realize you had your heart operation about 12 hours ago.

[Jamie Napoli]

Almost three years to the day since Marcel Deruder's LVAD implantation was swept up in a media maelstrom. The first total artificial heart operation was playing out in much the same way. But at least in the case of Haskell Carp, the publicity was serving a very real purpose. Lyota and Cooley's device was purely a stopgap. Haskell still needed a heart donor, and Cooley was gambling that the front page news coverage might help them find one. The morning after her husband's surgery, Cooley invited Shirley Karp out in front of the cameras.

[Narrator/Interviewer]

Someone somewhere, please hear my plea. A priest wore a high heart for my husband. I see him lying there breathing and knowing that within his chest is a man made implement where there should be a God given heart. How long can he survive?

[Jamie Napoli]

Shirley's pleas were Almost immediately, the calls began coming in. But for various reasons, none of the hearts was a good fit. One donor heart stopped beating while in transit from East Texas. Several calls came from individuals offering to end their own lives in order to save Haskell's. On April 6, with Haskell in critical condition, the hospital received a promising call from the family of a comatose woman in Massachusetts. Within hours, a Learjet was on its way to pick up the potential donor. Three flights, one emergency landing, and a frantic ambulance ride across Houston later, the donor heart was ready to be transplanted. By now, Haskell Karp had been living with the Leot Coulee device for 64 hours longer than any of the animal test subjects. Cooley reopened Haskell's ribcage and performed a swift and elegant transplant. Once again, a human heart was beating in Haskell's chest. It wasn't long before his health started to deteriorate. Things were going south. Kidney failure, pneumonia were now the big concern.

[Narrator/Interviewer]

They dumped a bunch of steroids in him and just really immunosuppressed him. And 32 hours later, he died. Just too much immunosuppression.

[Jamie Napoli]

Four days after his first operation, Haskell Carp was dead. But the total artificial heart had allowed him to live long enough to receive a transplant. It was the first step toward a future where humans could survive with machines in place of their hearts. And after a career spent in the shadow of Michael DeBakey, Denton Cooley had finally stepped out into the spotlight. His face appeared in newspapers and TV news programs. Reporters all over the world were saying his name. And for a very different reason. So too were administrators at the Baylor College of medicine. Even before DeBakey returned from Washington, D.C. the Baylor committee on Research Involving Human Beings gathered for an Emergency meeting, here's Dr. Gerald Lorre again.

[Narrator/Interviewer]

I think it was pretty clear that this wasn't unauthorized use. This artificial heart was being developed under a federal government contract and there were very stringent requirements in place to ensure that there would be a significant pause and review at the end of the animal phase before it was put in a human.

[Jamie Napoli]

As for Cooley's claim that the total artificial heart was an original design distinct from Liotta's work at Baylor, Michael DeBakey insisted that this was nonsense.

[Narrator/Interviewer]

Now, Dr. Cooley had no experience with the artificial heart program at all, didn't do any laboratory work. He was a good surgeon, but that's all.

[Jamie Napoli]

While the Leota Cooley device made use of unique tilting disc valves, Leota would later advance admit that he'd taken other components from his artificial heart work at Baylor. And when Cooley was asked whether the heart he used was DeBakey's, he replied, Yes, I guess in effect I took it. Cooley continued. I just couldn't let another man die on the operating room table.

[Jasper AI Advertiser]

This show is about modern mavericks, risk takers, builders and rule breakers pushing new frontiers. At Jasper, we know that spirit we're doing for marketing what these cardiac cowboys did for medicine. Throwing out the old playbook and building something radically better. Jasper is the agentic content automation platform that helps marketing teams move fast and stay in control. Whether you're launching a product, optimizing web content for LLMs, expanding campaigns and into new markets, or scaling audience personalization, Jasper gives your team a repeatable intelligent system for orchestrating content at scale. Unlike generic AI tools, Jasper doesn't just write with structured workflows, brand safe automation, and built in intelligence that understands your voice, audience and goals. Jasper replaces scattered tools and disconnected processes with one seamless content pipeline. It's already helping thousands of teams reduce production time, cut agency costs and publish more content that's actually, actually on brand. If you're a marketing leader looking to transform how your team works, or just trying to keep up with the pace of change, check out Jasper AI. That's Jasper AI.

[Jamie Napoli]

When debakey arrived back in Houston the Monday after the operation, his first step was to form an investigative group to determine whether there had been a violation of government guidelines and if Baylor could be held responsible for it.

[Narrator/Interviewer]

Dr. DeBakey was most concerned about the impact that this activity might have on all other research and funding coming from the federal government.

[Jamie Napoli]

That's Dr. Kenneth Maddox again.

[Narrator/Interviewer]

Theoretically they could removed and killed all federal research. Baylor was really depending upon that research.

[Jamie Napoli]

For financing the school for Denton Cooley, on the other hand, DeBakey's response felt less political than personal. Here's Dr. Billy Cohn again.

[Narrator/Interviewer]

Dr. DeBakey came back and looked at this as an absolute betrayal. He closed down the animal lab, fired everybody. Bud Frazier, actually. He was in Vietnam when all this was going on. And he recounts that being in Vietnam for a young heart surgeon was probably a safer place than being in Houston.

[Jamie Napoli]

Cooley accused his former mentor of instigating a global smear campaign against him, compiling a packet of false allegations and sending them to surgical departments all over the US And Europe.

[Narrator/Interviewer]

It was a personal attack. It was an all out war.

[Jamie Napoli]

That's Dr. Don Wukash again.

[Narrator/Interviewer]

Dr. DeBakey had plenty of reasons to be angry and hurt. It's not that one was right and one was wrong. They both were playing a little bit dirty pool.

[Jamie Napoli]

On April 18, DeBakey's investigative group concluded that the Leota Cooley Total Artificial Heart had been developed using DeBakey's grant money and that implanting it in Haskell Carp violated the government guidelines. Cooley was censured by the Harris County Medical Society, the American College of Surgeons, and the National Heart Institute. Over the next several months, he made a series of attempts to reconcile with DeBakey, but they were all either ignored or rejected. On September 2nd, he resigned from Baylor. Cooley devoted his full energy to building the Texas Heart Institute. He brought Liotta onto his staff. And for the next two years, it seemed as if the Haskell Carp fiasco was behind them. But Cooley and Liotta's problems had only just begun. Here's Haskell and Schwartz, Shirley's son, Marty Karp, again. When my mother first came back from Houston, she thought Dr. Cooley was a saint. Then some people try to, like, wake her up to reality a little bit. And not to say that he didn't have the best of intentions, but I feel like he was being an opportunist as here was a situation with a person that really had little hope. In April. In April of 1971, Shirley Karp filed a lawsuit against Cooley and Liotta, alleging that she and her husband had not been fully informed about the artificial heart or the fact that Haskell was participating in a human experiment. Supposedly he signed papers saying it was okay, that if there was nothing else that could be done in surgery that it would be acceptable to do this. My mom says he, he would have shared that with her, but I doubt my father would have shared it with her in advance because I'm sure she wouldn't have agreed, you know, he was making his own decisions. For the next year, the trial loomed over Cooley and Liotta. As always, Cooley managed to downplay his anxiety, exuding his usual self assured charm. He never really acted like things were bothering him to the daughters, or at.

[Narrator/Interviewer]

Least not to me, but I'm sure.

[Jamie Napoli]

It was terribly stressful and embarrassing. That's Dr. Louise Cooley Davis again.

[Narrator/Interviewer]

He just kept mushing through going forward.

[Jamie Napoli]

Because I think he truly felt like.

[Narrator/Interviewer]

He was trying to do the best.

[Jamie Napoli]

For that patient and for the development of heart surgery. On June 19, 1972, Cooley and Liotta arrived in federal court for the first day of their trial. Shirley Karp took the witness stand and testified about her confusion in the hours before her husband's operation. She felt the decision was rushed and that Cooley had been impatient for Haskell to give his consent. Implicit in all this was the accusation that by operating on Haskell Carp Cooley had acted not in his patient's best interest, but in his own. Cooley strongly objected to these allegations.

[Narrator/Interviewer]

I believe that we as surgeons have an implied contract with our patients to keep them alive. Think that there comes a time when the surgeon must assume certain responsibilities. And if it means taking a risk with his reputation, I think that he would be neglectful of his duty if he withdrew from that risk.

[Jamie Napoli]

Shirley Karp's case would hinge on the testimony of one man. As a preeminent surgeon and a leader in the field of artificial hearts, Michael DeBakey was perhaps the only doctor in the world with the qualifications to testify against Denton Cooley. Not only that, he had an axe to grind. When DeBakey was subpoenaed as an expert witness for the plaintiff, he was positioned perfectly to exact his revenge and deal a death blow to Cooley's career. And yet he didn't. Speaking privately in the judge's chambers, DeBakey asserted that he had no special knowledge of the case. And he refused to offer his medical opinion. Whether it was due to some lingering fondness for his old protege or simply a doctor's distaste for malpractice lawsuits, DeBakey had shown mercy. Without DeBakey's testimony, Shirley Karp's case became a lost cause. The judge delivered a directed verdict that favored Cooley and Liotta, and Shirley Karp lost again. On appeal, Michael DeBakey and Denton Cooley came face to face once more before the trial was over. Here's Dr. Don Wukash again.

[Narrator/Interviewer]

I remember that they had a break, sort of a mid morning break in the trial. So Dr. Keeley and I walked out into the hall and we came to a corner, Dr. Debacky turned the corner and there we were. I was in the middle and it was the most awkward moment of my whole life. I'm sure it was for them too. And Dr. DeBakey just looked at Dr. Cooley and didn't say anything and kept walking and Dr. Cooley did the same thing. So it was really a sad moment and an unfortunate ending for what had started out with them to be a father son relationship.

[Jamie Napoli]

Despite the promise of the total artificial heart, progress slowed after the Haskell Carp operation. Cardiac surgery was no longer the lawless frontier it had once been. And Cooley and Liotta had suffered consequences for their experiment that would have been unthinkable just a decade earlier. Today, the dream of a fully implanted, permanent, total artificial heart remains just beyond the horizon. The lvad, on the other hand, has become a common life saving measure for patients suffering from heart failure. Thousands of Americans are implanted with LVADs every year. That's thanks in large part to the pioneering work of Dr. Bud Frazier, a trainee of both Michael DeBakey and Denton Cooley. After the Haskell carp operation, DeBakey and Cooley's professional split forced many of Houston's best surgeons to choose sides.

[Narrator/Interviewer]

You had to make a choice. Who do you want to spend the rest of your professional career with? It's not an easy choice.

[Jamie Napoli]

In 1970, Life magazine printed a cover story titled A Bitter Feud, describing the ongoing war between Dr. Wonderful Denton Col Cooley and the Texas Tornado. Michael DeBakey DeBakey and Cooley's relationship had come to an end. Though they worked just a stone's throw from each other, it would be nearly four decades before the two men exchanged another word.

[Chris Pine]

On our next episode, Walt Lillehei's years of living and operating on the edge finally catch up with him. And Houston doctors attempt to bring a decades long feud to an end. Next time on Cardiac Cowboys.

[Jamie Napoli]

Cardiac Cowboys is a production of iHeart podcasts, OSO Studios and 13th Lake Media. We're presented by Chris Pine and written and narrated by me, Jamie Napoli. Our executive producers are Christina Everett for iHeart podcasts, Dub Cornette and Jason Ross for OSO Studios. Dr. Gerald Ember, author of Car Cardiac the Heroic Invention of Heart Surgery Dr. Eric A. Rose, John Mankiewicz, Joshua Paul Johnson and myself. James A. Smith is our supervising producer. Editing and sound design by Joshua Paul Johnson. Our composer is David Mansfield. Our cover artwork is designed by Alexander Smith. For more information on the first cardiac surgeons, check out Dr. Gerald Imber's book, Cardiac Cowboys, the Heroic Invention of Heart Surgery.