Donald Brian Effler, a pioneer cardiac surgeon, died at age 89 on 24 August 2004, at a nursing home in Jamesville, New York. He was born on what is now known as Roosevelt Island in New York City. He earned his undergraduate degree from the University of Michigan in 1937 and his medical degree from the University of Michigan Medical School in 1941. After serving in the Army Medical Corps during World War II, Dr. Effler joined the surgical staff at the Cleveland Clinic, where he became chief of the thoracic and cardiovascular surgery department from 1949 to 1975. Afterward, he developed the open heart program at St. Joseph's Hospital in Syracuse, New York, from which he retired in 1985, in declining health.
During his years at the Cleveland Clinic, Dr. Effler, along with Laurence K. Groves and other eminent surgeons, established that institution as a world-renowned center for cardiovascular surgery. Dr. Effler was particularly interested in myocardial revascularization and in the treatment of constrictive pericarditis and ventricular aneurysms; he published numerous reports on these topics. He investigated cardiopulmonary bypass with Willem Kolff, who was then also on the staff at the Cleveland Clinic. Their animal experiments with cardioplegic agents using potassium citrate solutions eventually contributed to clinical experience with intracardiac surgery on the quiet, bloodless heart.
Dr. Effler's most notable contribution was to the surgical treatment of myocardial ischemia. He was an early proponent of intramyocardial implantation of the internal mammary artery (the Vineberg operation). With the introduction of coronary arteriography by Mason Sones in 1958, Dr. Effler began to promote the direct treatment of coronary occlusive disease. He and his brilliant trainee, René Favaloro, lectured extensively on this subject both at home and abroad. At the 1969 annual meeting of The Society of Thoracic Surgeons, Dr. Effler stated, “Only a few years ago papers on [myocardial revascularization surgery] were viewed with frank skepticism and the authors looked upon with suspicion…. Last year when I attended two national meetings of surgical significance in this country, I heard only two papers related to the subject of coronary artery disease, one at each meeting. The subject of myocardial revascularization is timely and deserves more attention at surgical meetings.”1 He and Dr. Favaloro were instrumental in convincing the medical and surgical professions of the validity of this method.
In 1968, Dr. Effler and his colleagues performed the first cardiac transplant in the Midwest. In the early 70s, he helped establish the Philippine Heart Center, in Manila, which became one of the leading cardiovascular institutions in the Asia-Pacific region. He also operated on crown prince Khalid of Saudi Arabia, who later became king of that country. In addition, Dr. Effler edited a major textbook, Blades' Surgical Diseases of the Chest, 4th ed., which was published in 1978.
He is survived by Joanna, his wife of 60 years, and by 3 children and 6 grandchildren. His pioneering contributions will remain an ongoing source of pride for his family and an enduring legacy for cardiac surgeons worldwide.
Figure. Donald B. Effler, MD (Courtesy of the Cleveland Clinic Archives)