 Thank you, John. Well This has been during the been serve a blessing and a curse because all these pumps Had a relationship to the harnesses even the pulse of pumps but but The only work that was on the continuous flow pumps, which is what? We're using today was done here So Problem with that Is now that everybody thinks it's a good idea, which nobody did When I started out is I have to write all the book chapters. I've got the sixth book chapter. I'm writing right now but Anyway, we'll touch on some things here. I'm sure most of you in the audience would give this talk How does this work? Yeah, don't do anything See You're gonna turn it on, you know All right. Well, everything started started starts with dr. Vicki you can we always thought he looked a little Like Groucho Marx, but let me tell you he wasn't He wasn't funny. He was anybody says I like dr. Devaki, you know, they never knew him It's like saying you like Hitler or something There's nobody who's meaner or tougher than dr. Devaki But then I've grown older But began to appreciate him, you know, and he couldn't exist in today's World, you know firing everybody fired Out of my year there were 20 of us started 1970 and four of us finished The year ahead of me. There were seven Residents out Baylor had room for six. You can have six chief residents and training So he knew he was gonna fire one. I was all the whispering in the halls who's gonna fire He fired five of them. So there was only two Left Anyway, I think he was a little over to the zealous with that but but he did Do a lot of not a good things for this field the This was a Baylor when he came here and this is a Texas Medical Center when he came here and He told me that he came when he came He in 1948 this was 1948 That he heard gunshots and he didn't know what the hell And it turned out it was I don't have a pointer on this but anyway, he was They were hunting deer there were still some deer out there. So Anyway, it's a major goal now as far as my research work is concerned is to perfect the artificial heart now this was 1964 but starting in 1963 I Got involved with Dr. DeBakey on the artificial heart Not because I was interested in it But I was a history English major. I wasn't that interested in science Anyway, it's pretty boring still is and the But everybody had to do a research project at Baylor when I was a medical student and I One of my fraternity brothers was in my class or just 75 students in the client And he was one of these guys that was a real gunner. He was always ahead of the Head of the curvy and he knew that I never did anything at all until the last minute and Since we started we had to have a the as freshmen we had to have the title of our research project by November the 1st and I was standing at the elevator over in the juris research building at Baylor and He comes up to me Frank Polk He says, what are you doing for your research paper? This was October the 30th? And I said I've got another day. I hadn't thought about it And he said look you don't have to do anything. I knew you would have done anything I'm signed up to do research on the artificial heart with Dr. DeBakey and Domingo Leota who actually did all the work and I had to I had to have another person I couldn't do it all so I've already put your name in all you have to do is show up Tuesday in the lab and that's how I got in the field and Unfortunately Frank had a sort of an intentional tremor and he Dropped out after the first year and sort of left me in it for the all my years as a medical student working on this thing and I remember Dr. DeBakey telling me that by 1980 there'd be a hundred thousand Americans with artificial hearts Well, this was 1964 problem Well, it turned out to be a little trickier than just making a postal heart which was easy But one that'll last is a little different problem. Let me see they Most of you know this but some you don't there's always The your government doesn't do anything. They send out requests for proposals and have the private companies compete for it and that's That's why the the b-17 is Not bomber 17. It's Boeing 17 because they won the contract and and but And and that's what they started in 63 and Dr. DeBakey was behind this that was where he was very important Nobody was doing heart transplants. Nobody thought they were feasible. Somebody was doing some research in it the meet Leota as I mentioned Domingo Leota who was very important in the early days of this was doing some work and in Argentina and he presented a meeting at Osayo in 1961 and the baby asked him to come here and Work on the artificial heart. So that's how they started the project at Baylor and Here's one of the reasons we got all the money was of course was Dr. Vicki was in in LBJ's pocket and Or maybe the other way around Here's a You know, we always thought Dr. Vicki was either a mutant or product of an alien visitation from Lake Charles, Louisiana Nobody could work as hard as he did he was there all the time We notice, you know, LBJ's head That's like most people but look at Dr. Vicki It goes back up to 45 He's some sort of alien But his ears were a little pointed to but There's nobody worked harder than he did. He was tireless and he did a lot of good things Among us this was actually a lot of money and That's what and Baylor did all the Meaningful work in it and because Dr. Vicki got the money and And that was an important thing Of course, this is a nice thing. This was I think 1965 time Artificial hearts just right around the corner And we had look at all these things that's what Domingo Liotta would make these things look like, you know, you can make him look like they're for a science High school hot science project, you know, it just Making your garage because he did he'd made him by hand up in the old Baylor lab This is the way Baylor look or the medical center look where I started here and It We the medical students had to park here And we had to walk all the way over here Now they park they've got a parking lot in Fort Bend County somewhere Fraying it, you know but But it you know as I said, it's we've had the largest medical center we were thinking the heart is just a pump and It seemed logical that if that's the main function you ought to be able to duplicate that Yeah, it looked pretty easy But and it was easy to make a pump But one that beats a hundred thousand times over 24 hours in the last 70 years is a little bit more of a challenge This of course, this is when dr. Cooley came he was with Blalock and who was the premier Congenital heart surgeon, he never did an open heart surgeon in life, but he did a shot the blue baby shot taking blood from the left arm down to the Pulmonary artery and it's still gone and it still helps a number of patients and Cooley was with him when he was doing this This guy behind me is I'll star who made the first heart valve that actually worked is Cooley of course didn't have much to do with him because he was a little Short he's standing on something behind him But Anyway, so Cooley comes here and Cooley has the the Baylor program All this is serendipity just at when they started St. Luke's The they couldn't afford a children's hospital There wasn't enough money to pay for a children's hospital. There's no insurance then and yeah, and so they it was part of St. Luke's and St. Luke's had the Episcopalians and they always had more money than they could spend so they supported Texas children's the key to that though was that's why Cooley had privileges at Texas Children's Which also many had privileges at St. Luke's all the other surgeons At Baylor worked under Dr. DeBakey at Methodist and more or less he controlled them But Cooley could do a lot of things on his own and nobody knew anything about Conditional heart surgery of other than Cooley. He would have been visited Lollahy in 19 I don't know what's wrong in the fall of 1955 and been through these slides live and They saw Lollahy do He did Lollahy did the first successful heart surgery. They did it with cross circulation that is I Hopefully you mostly know what that is But he took the parent of the children because heart surgery then was congenital heart surgery and hooked the parent up To the baby and use the parent as a heart lung machine and He got survivors because they had no survivors with open heart surgery after Given did the first successful case 1953 that was a an ASD closure and a girl who was 13 years old and I think she's still living But the next four he did all died and he never did another case and in fact the next 26 cases they were done with an opener with a heart lung machine all died so and and a lot of those were Lollahy's because they That's why he started using the parent as the heart lung machine and he was the first one to successfully do Open heart surgery, but he had to have the parent there and Cooley went up there with Dan McNamara and They Came back and he's made this heart lung machine. It's up there in our museum now We totally the vacay had stolen Steve. I go found it Somehow a few years ago. So we've had it. It's a coffee maker and that was the first Heart lung machine that was very successful here is as Cooley used the You know normally they had the coffee up and quit it What is it? Anyway, this was a coffee Was at the top and it dripped down so he just put He puts steel wool to to filter out the air and bubbled oxygen through there and He did the first case in Houston With this in April of 1956 And it was a post-infarct VSD, which we still have trouble getting through today, but Cooley somehow got Got the guy through and And this of course Started out the open heart surgery and he he could do it because he did it at St. Luke's Probably he would never pulled it off if he would been a methodist And so Cooley had the best results in the world and the reason He had the best results in the world, of course, there's no reason for people to come to Houston but He as you can see Was his pump time it's all the way in seconds and That the bubble oxidator which what it's all they had that that was a mortal Operation it destroyed the blood and that's why everybody died basically with it until Cooley started doing heart surgery and the they had these The the pump times is always for were always in seconds, you know It's an eight minutes and forty-two. I Used to have a lot of those. He never had a pump time more than 18 minutes and Because of that He reported 95 cases was nine deaths 1956 the male clinic in the University of Minnesota were the only other places Doing open-heart surgery then and then the same year the whole year. They'd done 58 cases with 38 deaths so if you're gonna Have open-heart surgery you tried to get to Houston, you know, and that's what built this place and it and I went through this already with you and This was one of the animals we were doing and Frank got in this picture. I didn't know they were coming to take pictures, but he did so he's slipped in but but anyway but the Longest animal survivor they had was 40 hours and a lot of it was because I've already told you that story. That's gone a lot of it was because the The Dr. Devaki got resting Did a lot of good things but if you were in In this medical center in the 70s And you needed heart surgery and you knew who was doing it Dr. Baki would be the last one you'd choose because he was 52 years old before he even did any heart surgery and But that was one of the Problems that dr. Cooley got around again by Doing the heart surgery over here and having his own heart-lung mission Now the transplanted hearts were very important because the mechanical device has always Wrote on the back of the transplants and of course Christian Bernard who I got to know very well what time did the first heart transplant in 1967 December 67 Whereas some way been working on it for years and years and years, but the problem was they couldn't decide on brain death because Death was a legal definition then in the US. You had when you lost your pulse So they hadn't they knew they couldn't do it unless they had a viable heart so they had to decide on brain death and and of course Christian Bernard just did it And I asked Christian Bernard later when I got to know him in the 80s and I said, well, how did we were you able to do it? He said well, you know in the US they were arguing they had the Harvard committee on brain death That's the last thing you wanted the Harvard committee on brain death because they were arguing about it for a year and a half and And and he said they could never decide But in South Africa You were dead when your doctor said you were dead and that was The way he could get a donor and once he did it then of course everybody started doing it And after Cooley he did the first the successful here is with Chris Bernard. He did the first successful heart transplant in the US in some way had done two they died and Adrian counterwits had done One that had died, but Cooley did one Just pulled it out of the air, you know the luck of the Irish in April of 68 and the guy lived for over a year This was of course, this was a difficult scene in Cooley's operating room. There's such a Outstanding surgeon you can hardly find him in here But this was they were having a national meeting in Houston and of course everybody was going to watch Dr. Cooley operate because They had a rule at St. Luke's you can only have three visitors, you know, well lots of luck on that But and they put a bunch of petri dishes around to grow the bacteria and show Dr. Cooley how dangerous it was But none of them grew any bacteria. So he got the last laugh on the nursing administration Anyway, as I said Cooley Did the first successful one and more were done in Houston than anywhere else because Dr. Devaki got in the act because mainly because of Ted Dietrich and and So in the first hundred in the world 26 were done in Houston, and of course Cooley did the most Now Leota became obvious with Leota. It was I went to Vietnam in 68 and so I was gone during this period and Dr. Leota knew that Dr. Cooley would never implant one I mean, I'm sorry. Dr. Devaki would never implant one He was right because it took him too long and all the animals died I remember being over there when he did them and you know He'd be on the heart-lung machine two hours with the animals Now you could put a calf on the heart-lung machine two hours above an oxygenator not do anything They would all die. So it had nothing to do with the pump, but the pump worked well So Leota started coming over trying to get Cooley interested in it was doing all these Heart transplants and and use it as a bridge to transplant. This is the minga Leota and the pump This This is the water valve and The water valve is why we have the FDA Because it was the first valve It didn't want a ball valve. So it didn't it wasn't obstructing and Dr. Cooley put more of them in than anybody. The problem is after about six months they started flying out and they realized that That there was never any animal studies done and So they added that to the duties of the FDA to approve all the medical devices There was no medical device approval. There's no balloon pump approval. It's never approved with the FDA Etc. Etc. The heart-lung machine was never approved but the water valve is what got us in The problem with the FDA and they were right. There should have been if they had done it one calf With this valve with the hyperdynamic heart It would have fallen out in two weeks and you would have known that it would have never worked in patients but anyway, that's something very few people know because Cooley always wanted to keep it quiet Because it started out being the Cooley water valve and then Dr. Cooley got his name off of it he was sued for 30 million dollars and He said in the Houston paper that He hoped we didn't lose because he might have to go into a savings account to pay it off It's probably the worst thing you could have said, you know, but they finally dropped here But it was the cutter company made it and they had to declare bankruptcy or Anyway, this is the first total heart implant and This is Haskell Karp who was done. He was a patient that they couldn't wean from bypass and They put the heart in this is Leo and there's dr. Cooley This was the controller little a little bulky, but it worked actually the pump worked well and He you know, this is a pretty good chest x-ray he was awake and excavated right after the surgery and he was talking to them and when they Transplanted him after 72 hours, I think so the pump looked fine, you know, of course, there was nothing In that period of time, but it was also Covered with cells. This was the Dacron flock Dacron and that was after the Vakie's idea probably a little like a lot of things that are you know Success has many fathers failure is always a bastard It's hard to know whose idea it was but certainly doctor make the possibility has now been established As a reality the fact that mr. Karp has regained Organ function in terms of cerebral function and kidney function indicates that it's Mechanical heart is a feasibility There's much to be done now. It's much like embarking on the space program We know that a rocket will go up off of the service of the earth But we haven't set foot on the moon yet Of course, this was in April of 69 and in July 69 we did set for the moon but and of course He wrote it up and he was good about that and you notice the absence of Doctor to make his name on this So it was and Cooley knew dr. Vakie was very predictable And he knew the doctor to make you would go through the roof on this and The truth is he wanted to get out of Baylor You want to get out for the medical school more than anything else? He told me later. He could survive dr. Vakie was it just couldn't survive the medical school was the Biochemistry committee telling him how to do heart surgery and that's all and I've learned to appreciate that Anyway, so they had this big fight. He gets fired. Leone gets fired. I was as I said, I was in Vietnam And the salt helicopter company in Vietnam I got shot down Twice they had that I was in the helicopters that had to auto rotate down That's how I ended up getting four back operation but We were in a combat. There's a assault Combat assault helicopter company and I had to fly on all the combat assaults because my Commander I was the only person in the 350 men There's a 1968 350 men in an assault helicopter company and there was only one other that had a college degree and the rest were mainly poor boys from the South that got drafted and One other guy got killed After the first two months. I was there and My commander had an 11th grade education. He was always telling me what to do Clearly I didn't get along with him very well But I wasn't pretty good shape then my daughter doesn't believe that's me. She thinks I had a some sort of stand-in That was one of my medics Dr. Cooley had no experience with the artificial art program at all didn't do any laboratory work. He was a good surgeon But that's all the doctor the bakey seemed to show a little anyway But he was right about dr. Cooley because what he said initially was that dr. Cooley didn't care about research. He'd never done any research. He'd never been in an animal lab He just did things because he was so gifted. He was such a gifted surgeon and But and he wanted to get out of Baylor and he knew not to make it was very particularly fine but he also fired Leona Because he was a culprit a co-conspirator in the thing so Leona leaves and But so he doesn't have a lab. So dr. Cooley actually feels guilty about that and that's how the the our lab got started and dr. Cooley who God rest him. He would never spend a nickel on anything It didn't matter how much money made he made 18 million dollars in 1982 later came out in the bankruptcy more than more than the Beatles made but He He wouldn't spend any money for the lab. So he got the culling Family the culling foundation So our lab is called the culling cardiovascular research lab And that's how our lab got started. It's the only in vivo lab really in the country now probably in the world certainly the only one that can do cash and it But this was where it started with this feud and And it was important because it showed the feasibility of our physical heart there's all sorts of discussion again about this and that and But he woke up. He was fine. They should have left him on it But Cooley wanted to get him Transplanted as soon as possible obviously They really didn't know what the outcome would be because there were no animals Survivors, so that was true, but not because of the pump. There's a pump work. Well Anyway, that was How we got a lab here and how It it was in all the all the devices in the world came From our lab. They're being used in the world today The transplants failed as you know that first era of transplants fail and that Was why they started the the the support of the Elvads and and they were initially supposed to be permanent elvads. Well, they know what permanent meant So they decided two years. There was no doing it. There was no heart transplants in this error because they stopped doing them except with Shumway in Stanford and This was the an early RFP, but it was It was to be electrically controlled out Nothing penetrates the body nothing and we'd we'd work that out we can power that we did in the 70s You don't need a Drive-line to power these things you can power them transcutaneously. That's as old as Tesla, but and What and we couldn't do it With these postal pumps Not because of the pump but because of the compliance chamber. We couldn't get a compliance chamber that would last Two years and that was the RFP had the last two years the pump would last two years but not the compliance chamber so We started just vending it to the outside through a drive through a drive line It was you know, it was vented and we had we ran the power through that as well and we had first patient to relieve the hospital was a patient I did in 91 and very important because this had gone from You know a huge console to a guy out Who's dying of heart failure when we put it in he's out playing basketball three months after we put it in So and I think it was really a very important Mike Timberlain was a patient name Important step because it shows that you could have an untethered L-vine and And it all these albides that we worked on were the first ones approved by the FDA Now I got interested in continuous flow because I knew these postal pumps would never last more than about two years The diaphragm would wear out as I said the fact that it lasted two years. That's 36 million Excursions in a year that it didn't wear out before that is what's quite an achievement We didn't need a two-year pump Because by then we were doing heart transplants. So it would only be a bridge to transplant And we didn't just like today. We don't have enough hearts to do Transplant so it wouldn't actually work in improving epidemiologically Anything because It was just adding people to the transplant list and So and that was one of the things that stimulated me about working on continuous flow pumps the other ones I knew they could be smaller because one of the restrictions of the of the postal pumps was the size and and we needed a pump that could be used in children and smaller adults, you know particularly women usually a little smaller and We didn't we put very few of those postal pumps and women So we had to develop a smaller more durable pump and as I said these postal pumps all fail and You can't be replacing it over two years the size and the durability here The size of the pump you can see was a big barrier Shumway who was a great power of mind down through the years, but he always Pointed this out that it had no epidemiologic value. So the question was of course, do we need a pulse? Well You're required to have a pulse it never existed outside of any mammal in the world And you had to have a pulse because the heart had to get blood the heart had to get blood So it had to rest not for systole. You had to have it for diastolic but I also knew that it was something that we If you look at the eye grounds you see the capillaries and The blood runs continuously at the capillary level and I knew that I knew enough about Anatomy and biology to know that at the cellular level you don't need a pulse The There was no funding for this and I Paid for it myself all the animal work through the transplant research fire That I had because you get paid believe it or not $2,500 for taking out the heart just for the transplant which it's a ten minute operation, you know and I was called Probably I said the first heart transplant here in 82 probably about 84 85 the organ back call and said we got Over a hundred thousand dollars over there. I said for what? And they said for hearts in the heart. That's it. That's a nothing operation. You can't get paid for that They said well everybody else is taking it and we can't keep it here. I'm sure they were trying to and So I set up the transplant Research fund so all the hearts that we did and we didn't want anybody in the country do the 80s and The all that money went in the research fund so that's what funded all the continuous flow research the NIH was funded the The postal pumps but make millions of dollars where they spent nothing on the continuous flow pumps and The one of the problems there were two problems with it continuous flow one was the bearing because You had to have a bearing the only thing pump we had was an actual flow pump You couldn't lubricate a bearing in the bloodstream So Jari can I worked all that for over five years and he did a great Accomplish the great thing because he finally figured out a way to have a bearing that was blood washed and didn't clot and They they've never failed none of these pumps have failed The heart made two has been in patients 17 years. I thought they would fail But after five or six years anyway, but they haven't and that's why we started working on what do you call the heart make three? We started working on that 1994 nothing new about it, but The he will pop the other thing Whopper showed that The idea was if you had a pump pumping more than 2,500 rpm, it would destroy the blood So you couldn't use that well whopper had this hemo pump that we worked on in the experimental animals and Showed that it didn't himalize and we put it and it would spend it spent at 25,000 rpm And that's that's the impella. You know that as the impella today But and we showed both of those things that are what made the Continuous flow pumps Possible and I said they were sort of a Basis of all these implantable pumps Norma to ended up It's outside the heart, which is a problem the Jarvik I told him to put it in the heart And actually it's the best pump because of that But you see these bearings they just copied Jarvik and I don't know how Jarvik I'm gonna wait with it, but They did and and these bearings is a little red things. They just Last indefinitely. I don't know how they're still working at 17 years but And the good thing about a heart mate too Thorntech never did anything they never did any original research or anything. They were just a business which I guess is important because they made the pump and they made it commercially available and that that's what people use and And of course All the initial pumps were done here, but it's one thing to remember that I never got along very well with the Thorntech guys for some reason or another and they they So they did some of their original research at Pittsburgh and at Pittsburgh They took the pump that they developed at Pittsburgh and they wanted to try it out in the Germans first See if it would work. They I never did that always do them right here, but they put it in 13 patients in Europe 12 died within two months within a month actually the one only one that lived They took the pump out after Two weeks my dear cube and one night so it clearly didn't need But then they brought it to me and they they had put the serratanium that we use on the postal pumps which which meant that we didn't have to use any coagulates on the inside of the pump and I Showed them that if they did that Then the pump would clot and of course the guys Working on it said well it didn't clot in the postal pumps. I said well the postal pumps have this huge surface and you've got you know 50 microns of clearance and that's what why it clotted in the In the patients in Europe it didn't in the animals either the animal has a hyper dynamic heart the calf particularly so it shows you the capriciousness of the animal studies and and how Something like that was just You know basic to me. Anyway, I told to get rid of the serratanium And I'd put it in a patient. I'll put it in the first heart made two clinical woods And I put it in in november of 2003 Anyway Right on this this is a heart made two patient All right, we have five years you wouldn't you didn't want a transplant because he was a smart guy The transplant long-term survival is not changed not changed something to the at all since the 90s They have a 90% one-year survival now because we transplant a lot of people don't need it that's the The government is firing And it's a five-year 15-year Survival is about 15% 20-year survival Five percent now because of the Kaplan Meijer you can Make it look a little different in the Kaplan Meijer I've had a transplant patient 35 years for neck counts 35 years Five years They had a camera pulse ready to come out We took it out and after it had been in five years and he's Been out eight years now so it is That's something that that We need to look at more. It's recovering But this was in 2019. There's been Over a thousand patients with a heart rate two out over 10 years and I had a patient from Arkansas calling not too long ago and Well, it was two years ago She was sick as a goat when she came down to Arkansas. She's in her 60s And I we put a heart rate two in and I sent her back After two months. I thought she died and I never heard from her again and she called me in in 20, I guess 15 years later and it was caroline and I guess I shouldn't mention the name, but anyway caroline I pick up the phone and She said it was caroline. I said caroline. I thought you died And she said well, I thought you died because I never But she'd had no cardiology care They she was on a low dose of anticoagulants And she's she went 17 years. She broke her hip a few months ago and In Arkansas and died with complications that but the pump they had to cut off because it was still running So these pumps have not been pumped to failure Anyway, I just think So one of the things I want to talk to you about Sanjay has already talked to you about Well, he didn't talk to you about this. This is a pediatric pump. I'm working on and this We we got a four million dollar r01 grant And I'm the PI on it. Although I did none of the Grant writing I'm not going to do that again, but for some reason they put me as PI and I'm the oldest PI on an r01 grant and NHLBI history, but This is the size of this little pump. We're working on it in our lab up on the ninth floor right now Dr. Lang from China, you know all these smart Chinese and she's She developed It was my idea to have a small pump But I never did any of the engineering and I'm as I said, I don't know anything about I don't like it And uh, but I told them what we needed and we needed a small pump that we can put in through the uh Subplavian vein put it into the left atrium and pull it out And unload the heart and that can be done. That'll be done We'll do that within about two years But we also need one for children and this is also Going to be done for that. We have we have a one bearing in this and We're she's going to get rid of that bearing with a magnetic suspension And uh, as I said, this is where we The way we hope we're going to implant this pump And and uh, there's no reason why it won't work, you know again historically This was done in the 50s by Clarence Dennis Taking a Kangler through the internal jugular vein and poking it into the left atrium and that And he and he did eight patients with That and of course they all died, but it worked the pump worked and This is the way I think this will work and we'll pull the blood out into the Subtlaving order in With this you can unload the heart easily and put it in a patient that's uh What we call a class three heart failure symptomatic but not homebound and not in the icu which The pump so we put in now that they should all be that's sick before you put it in But this one you could put in easily and you can take it out easily. It's just And uh, and you don't have to open the chest Now the total heart replacement again We I've got these lvads filing But and most of these lvad patients don't have a pulse which is wrong the reason the lady has survived and it Arkansas so long as It unloaded the heart you need about a two liter flow to unload the heart And she still had a pulse so it was working in parallel But most of these patients don't even have a pulse and that's where they get the complications of stroke The GI bleeding all that's been described And uh, I wrote it up in 2005 and they should never be without a pulse Because that's where you get the complication Anyway, so This is another reason as I Said that they're inflow sensitive that is as the inflow pressure goes up then the uh Then the pump pumps more and that's The any engineer can tell you that if you if the inflow pressure goes from five centimeters to ten centimeters And a pump flowing at 10 000 rpm Its output will go up to about 14 Lead from 10 to 14 liters without changing The pump at all so it has an automaticity of the starling's response We started putting this and we put this in a patient actually Billy comb and I did in uh 2011 But actually the first one thing we'd done is 2005 we'd done to the animal with us and and It went quite well. There was no pulse at all as you can see in this This is a patient actually and the the patient that we did woke up and did beautifully in a sort of sclera sarcoid to the heart that had already Metastasized and we didn't know what we put these in Anyway, it worked fine. This is the patient He actually woke up. He'd been intubated on a heart loan on a respirator He started working. He was an engineer When we realized he had the the sarcoid in his liver and lung He cut it off now this engineer from You know Sanjay has already talked to you about this but this engineer from australia contacted me in 2004 We started putting this continuous flow total artificial heart in in 2004 and uh, I think Sanjay showed you most of this But it just has one moving part and it's magnetically suspended. So there's no where at all in the pump but it has nothing that it touches and and as I said unlike what dr. Devaki was dealing with in the 60s This is a technology that We just wasn't even available and you can make it a pulse with it. It's not really a pulse But it looks like a pulse and that's all you need for the cardiologists and nurses They don't like to see a straight line on the arterial lines, but So we can make it look like that But it changes diastole from passive to active. So it does change the physiology a lot and I think these calves I hate to operate on the calves are the sweetest animals And uh, they put up with all this. This is a calf on a on a treadmill And it's a harness and these are the old days and uh As you can see this Little fellow ugly started walking And and without changing the rpm the flows goes up just like I told you with With the increased venous return the flow goes up To 15 liters and and it'll do the same in patient This is a size comparison to the abicor heart that heart in And from france is actually bigger than the abicor This is a pump this time made you go now as far as my research work is concerned is to perfect the artificial heart So that's was over 50 years ago. I think we're gonna do it But uh, and and I think we'll have this in patients within a year I was I remember talking to this irishman singer. I had dinner with him one time and uh One of the things he spent a lot of time to talk to me about the pump for some reason he knew about it and uh, he said the same thing that you know, uh he He thought he was successful because he wrote his own songs and this was one of the Points that I think he He uh, we we decided on and you can't be creative looking backward. Otherwise If if you have a good idea And you tell everybody all your friends you've got your idea and if they all say well, that's a good idea It's not a good idea. Somebody would have already done it Because every advance has ever been made in medicine was faced with the whole medical community opposing it So if you wait till somebody agrees with you, you'll never get anything done And uh, try to be creative All right, thank you very much