Miles Lowell Edwards (1898 to 1982)
Lowell Edwards came from a family of pioneers and entrepreneurs. His grandfather, Jesse Edwards, was a prosperous farmer in Indiana who moved his family to the frontier in 1879. The Edwards family established a farm a few miles from Oregon City. This settlement grew into the town of Newberg, Oregon. Jesse’s son, Clarence J. Edwards, married Abbie Laura Miles in 1893 and on January 18, 1898, their second son, Miles Lowell Edwards (who would be known as “Lowell”) was born. In 1904, Clarence purchased an electricity generator, powered it with a steam engine, and illuminated the streets of Newberg for the first time. In 1913, Clarence sold his business for a profit and moved the family to Tillamook, where he invested in another electrical power generation plant and made it profitable. Lowell helped in the family business, climbing poles, stringing wire and getting a practical education in electrical matters. Lowell Edwards built a wireless radio, the first in Tillamook County. He was encouraged to be self-reliant: One Christmas he asked his parents for a bike. On Christmas morning, Lowell found a box under the tree which contained some, but not all, the components of a dismantled, used bike. His father predicted Lowell would enjoy riding a bike that he had assembled.
Edwards graduated from Tillamook High School and then studied for two years at Pacific University. In 1920, Edwards entered Oregon Agricultural College in Corvallis. Edwards studied to be an electrical engineer and graduated in 1924. He applied for and received an apprenticeship at the General Electric Research Laboratory in Schenectady, New York. He spent three formative years at the Research Laboratory conducting research and using a variety of tools and processes to manufacture invention prototypes.
In 1927, Edwards returned to Tillamook, Oregon. He married Margaret Watt, and they established a home that included, as it would his entire life, a workshop. As an inventor, Edwards was a tenacious problem-solver. Margaret observed that Edwards, when working on a challenging problem, would awaken at night with an insight or solution, and go immediately to his workshop to record and test his idea. In an interview with the Santa Ana Register in 1958, Edwards was asked why he preferred a home workshop to a sophisticated hospital or industrial laboratory. He simply replied, “Well, I guess inventors are a queer breed.” For Edwards, invention was more than generating ideas; he was a hands-on worker, whose skills in his shop were a critical adjunct that enabled him to build and refine his own prototypes.
Edwards’s shop in Brightwood, Oregon
The Edwards family, now with two children, moved to Portland in 1929. Edwards began a successful career as an electrical engineer with an expertise in hydraulics and pumps. Despite the Depression, he invested in Bingham Pump Company, functioned as the company’s chief engineer, and helped it survive in difficult times. The company manufactured and sold industrial pumps, primarily to wood pulp-paper and lumber mills. In 1937, he sold his share in Bingham and accepted a position as plant engineer with Weyerhaeuser Company’s pulp mill in Longview, Washington. Edwards led a team that invented a machine that solved a major problem for Weyerhaeuser: the removal of bark from logs intended to be processed into pulp. The machine moved logs into fixed position where a high pressure jet of water, produced by a powerful pump Edwards designed, ripped the bark from the logs without damaging the wood. This device became a standard de-barker in Pacific Northwest pulp mills. While he worked on the de-barker during the day, Edwards worked nights and weekends in his work shop on another problem faced by pulp mills: pumping boiling water. The standard piston pump pushing boiling water through a pipe generated bubbles that slowed the flow. The unique spinning action of Edwards’s centrifugal pump separated the hot liquid from bubbles, which could be vented back into the tank. Edwards said years later that assembling his centrifugal pump prototype was his greatest challenge as an inventor. What he did not anticipate was that the pump would play a crucial role in improving the performance of US military aircraft in World War II.
In 1942, Boeing Aircraft Company engineers in Seattle, Washington were stymied by a problem with their new B-17 bomber. The aircrafts’ engines lost performance during a rapid ascent to over 20,000 feet because the volatile fuel would vaporize at low atmospheric pressures in high altitudes. Boeing engineers had heard that Edwards’s centrifugal pump was able to move boiling water, and invited him to demonstrate the capacity of his centrifugal to move volatile fuel. He was
, “highly pleased when they showed an interest.” After sustained effort, undaunted by setback and compelled by a desire to support the country in its time of need, Edwards invented a reliable centrifugal pump. He signed a lucrative contract with Thompson Manufacturing, a major airplane parts manufacturer. By summer of 1945, thousands of Edwards’s centrifugal aviation fuel pumps had been manufactured and were used in the majority of US military aircraft.
By 1947, Edwards was independently wealthy, and retired from Weyerhaeuser Company. Margaret hoped that her husband would embark on a leisurely retirement involving golf and travel. Edwards, who had no training in cardiac physiology, began to think about the heart. He reasoned it was a pump and he should be able to invent a device to replace it when it failed from disease. Edwards’s son, Dr. Miles Edwards, recalled that his father “was sick for one year as a teenager with rheumatic fever… He came out of this illness without developing a murmur or any evident impairment. Perhaps because of this he would always be interested in medicine, especially the heart.”
Edwards’s research laboratory, Multnomah, Oregon 1950’s
A pivotal moment in Edwards’s career occurred in the late spring of 1958, when the 60-year-old Edwards introduced himself to a 32-year-old cardiac surgeon, Albert Starr.
Edwards and Charles Dotter, M.D. in 1956. Edwards donated $25,000 to benefit the Department of Radiology in the University of Oregon Medical School Hospital, shortly before he met Albert Starr.
Starr, trained in New York, had recently accepted the opportunity to implement an open heart surgery program at the University of Oregon. At the time cardiopulmonary bypass was a risky procedure. Starr arrived in August 1957, and by the time he met Edwards nine months later, Starr had trained a team that could successfully put a dog on full cardiopulmonary bypass, using refined methods for working inside the animals’ non-beating heart. With the team trained in the lab, Starr had performed successful open heart surgery on children with congenital heart malformations. Edwards proposed that he and Starr collaborate on the invention of a mechanical heart that could replace a failing human heart. Starr convinced Edwards to focus on inventing a prosthetic heart valve. Edwards would construct the valve prototypes and Starr would insert them into the hearts of dogs.
Albert Starr, M.D. circa 1958
Within weeks, Edwards was sending to Starr prototypes he had constructed in his home workshop, which was now located at the family’s summer home in Brightwood, Oregon. Edwards’s first valve had a circle frame of solid Teflon that held two Silastic flaps that functioned as leaflets.
FIGURE 1: FIRST VALVE DESIGN
Starr sutured the first valve using ring of Teflon cloth attached to the prosthesis. It functioned for several hours before a clot formed and blocked the Silastic flaps and the animal died. Starr and Edwards developed a method for fabricating a Teflon tube of cloth material that provided a superior means of suturing the prosthesis into the mitral annulus.
FIGURE 2: INVENTION OF THE SEWING RING
After several prototypes with Silastic flaps, Edwards and Starr decided to work on valve design that had an oscillating ball inside a cage.
FIGURE 3: BALL-IN-CAGE PROSTHESIS
In the first dog, Starr inserted a ball-in-cage valve prosthesis into the mitral position. It was a spectacular success and the dog survived vigorously for months, with normal cardiovascular physiology. However, the inventors achieved long-term success with the ball-in-cage valve only after they developed a method of covering the suture line with a Silastic shield.
FIGURE 4: SHIELDED BALL-IN-CAGE PROSTHESIS
In 1960, Herbert Griswold, MD, the chief of cardiology at University of Oregon Hospital, learned of the durable function in dogs with a ball-in-cage mitral valve prosthesis. Griswold referred to Starr for valve replacement surgery a young woman near death from a severely damaged mitral valve. In August of 1960, Starr replaced her damaged mitral valve with a prosthesis Edwards had fabricated in his workshop. Her post-operative cardiac function was excellent, but she suddenly died 11 hours after surgery when air trapped in her enormously dilated left atrium embolized to her brain. This devastating outcome disheartened but did not discourage Starr and Edwards. Starr had learned a painful but vital technical lesson. Nonetheless, Starr and Edwards were encouraged by the valve’s performance. Four weeks later, Starr inserted a mitral valve prosthesis into a second patient. That man’s spectacular recovery and return to a normal life was dramatic proof that the prosthesis was effective and durable.
FIGURE 5: Patient Philip Admundson: First successful mitral valve replacement. Lucite struts in first 2 valves modified. Later human valves had casted metal struts.
On March 21, 1961, Starr and Edwards presented the results of their first eight patients to the prestigious American Surgical Association. Five patients with terminal heart failure returned to normal lives after insertion of the Starr Edwards valve. The manuscript published a few months later would be one of the top 100 medical manuscripts published in the 20th century. Mitral Replacement: Clinical Experience with a Ball-Valve Prosthesis. Starr A, Edwards ML. Ann Surg 1961; 154: 726-740.
Lowell Edwards and Albert Starr, M.D.early 1960’s
By 1961, Edwards concluded that clinical success with the mitral valve obligated him to establish a business that would produce high-quality cardiac valve prostheses. Edwards founded and incorporated Edwards Laboratory, convincing an old trusted friend, Ray Astle, to join him as the general manager. They rented space in a small building in Santa Ana, California, and with two employees began to manufacture Starr-Edwards mitral valve prostheses one at a time.
Edwards in front of Edwards Lifesciences Laboratory, Santa Ana, California. April, 1961
Demand for the valves rapidly increased in 1962 and 1963. Edwards and colleagues confronted major problems when trying to achieve reliable production. These were overcome through persistence and unswerving commitment to produce the highest quality valves.
In 1961, after their success with the mitral valve prosthesis, Edwards and Starr turned their attention to inventing a ball-in-cage prosthesis to replace the aortic valve. The function and anatomy of the aortic valve are substantially different from the mitral valve, and thus modifications to the original design were required. The four struts were replaced by three struts of reduced thickness, made of an exceptionally hard alloy, Stellite 21. The sewing ring had to be shaped to conform tightly to the high-pressure flows across the aortic valve. Edwards refined the structure of the aortic valve in incremental steps, attempting to achieve maximum performance. In 1963, Starr and Edwards reported their clinical experience with aortic valve replacement with what they termed their “semi-rigid ball-valve prosthesis.” Aortic Replacement: Clinical Experience with a Semirigid Ball-Valve Prosthesis. Starr A, Edwards ML, McCord CW, Griswold HE. Circulation. 1963; 27: 779-783.
Starr and Edwards receiving AMA award, 1963
In 1963, the American Medical Association recognized Edwards with its Distinguished Service Award for being “a man of honor and courage, whose inventive genius brought about development of artificial heart valves, and whose long devotion to human welfare in the science of medicine has given life and hope to victims of heart disease throughout the world.” After he sold Edwards Laboratory, Edwards remained interested in other inventions. He and Margaret were generous philanthropists, donating to Oregon State, Oregon Health & Science University and George Fox University. He died in 1982 and is buried with Margaret in the Friends Cemetery in Newberg, Oregon.
Edwards and wife, Margaret, 1972
Edwards was an engineering genius. A modest and unassuming man on the exterior, he possessed an intense curiosity and a capacity to resolutely focus on solving a problem. When he encountered technical problems he could not solve, he taught himself the new skill needed to accomplish the task. His extraordinarily effective collaboration with Starr
, demonstrated that Edwards could listen closely to the surgeon’s descriptions of problems inserting the valve, and invent solutions in the form of revised design of the prosthesis. No detail was too minor for Lowell Edwards. The story of the Starr-Edwards valve is not about a major breakthrough achieved in a single-step, but rather it is about two inventors with vision and ambition, undaunted by failure. Their method was to learn from each failure, rethink the options, and try again. There is no greater accomplishment in medicine than to invent a cure for a lethal disease; Edwards and Starr invented a device that restored health to thousands of desperately ill patients, threatened by their damaged heart valves.
-- Richard J. Mullins, M.D.