W. Dudley Johnson, Heart Bypass Surgery Pioneer, Dies at 86


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Dr. W. Dudley Johnson during a 1999 bypass operation in Milwaukee.

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Milwaukee Journal Sentinel

Dr. W. Dudley Johnson, who pioneered and popularized lifesaving cardiac bypass surgery and was considered a healer of last resort for heart patients around the world, died on Oct. 24 in Milwaukee. He was 86.

The cause was complications of a stroke, his daughter Susan Comen said.

Dr. Johnson was a reluctant surgeon — early on, he once recalled, “I disliked surgeons and their pompous attitudes” — but he applied the crocheting skills he had learned from his mother, who was a home economics teacher, and the needlecraft he was taught in a seventh-grade sewing class (he got an A), to perform more than 8,500 heart bypass operations over four decades.

“He received patients who had three alternatives from other doctors who wouldn’t tackle their condition,” Dr. Gordon Lang, his friend and colleague, said in an interview. “One was, ‘Go home and get your affairs in order.’ The other was, ‘Put your name on a cardiac transplant list.’ And the third was, ‘Go to Milwaukee and see Dr. Dudley Johnson.’”

In an interview with WMVS-TV in Milwaukee in 2014, Dr. Johnson said, “I find it very difficult to tell someone to go home and I can’t do anything for you.”

Doctors had experimented with coronary artery surgery since the 1950s, the goal being to remove accumulated plaque caused by cholesterol deposits, which can block blood flow and cause the stabbing pain of angina. One method was to remove the clogged portion of an artery and graft on a replacement patch of cardiac membrane or a segment of vein from a leg.

In 1968, Dr. Johnson and his team took another path, sewing segments of veins from multiple arteries end to end and stitching them directly into the aorta, the body’s main artery, bypassing cardiac ducts where the flow of blood was impeded.

His breakthrough, reported the next year, defied skepticism within the medical profession and heralded a new era of successful double, triple and quadruple bypass surgeries.

“It was perhaps the presentation of Johnson in the spring of 1969 that had the greatest impact on the widespread use” of coronary artery bypass grafting, Dr. Eugene A. Hessel II wrote in “Cardiac Anesthesia: Principles and Clinical Practice,” published in 2001.

To facilitate surgery, Dr. Johnson made another breakthrough by temporarily stopping the heart and slowing the body’s metabolism by cooling and circulating the blood through a heart-lung machine.

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Dr. Johnson, left, in surgery in 1999, applied crocheting skills he had learned from his mother, a home economics teacher.

Credit
Milwaukee Journal Sentinel

Wenner Dudley Johnson was born on April 3, 1930, in Madison, Wis., the son of Royce Johnson, an electrical engineering professor, and the former Olga Wellberg, who was from a family of Swedish immigrants. He went by Dudley.

He decided to become a doctor when he was in the eighth grade, he said, in part because he was fond of a physician who was a close family friend.

He earned a bachelor of science degree from the University of Illinois in 1951 and, after graduating from the university’s medical school, interned at Cook County Hospital in Chicago, where an admired senior resident changed his dim view of surgeons.

His first marriage, to Kathryn Ann Dicks in 1958, ended in divorce. Besides his daughter Susan, he is survived by another daughter, Sharon Bock, and a son, Stephen, all from his first marriage; a brother, Stephen; and four grandsons.

Dr. Johnson was married twice more, to the former Sharon Clark and the former Lois Reid, who died in 2012. Two stepchildren from his third marriage, Nancy Anthony and Jeff Swegler, also survive.

Dr. Johnson was drafted into the Navy, but because he was prone to seasickness, he said, he signed up for the Public Health Service. He had planned to be a general practitioner, but after leaving the health service he moved to Milwaukee and began studying bypass procedures with Dr. Derward Lepley Jr. In 1968, they collaborated on a heart transplant operation on a woman who went on to survive nearly nine more years, longer than any other transplant patient until then.

Dr. Johnson’s multiple bypass surgeries, which could take as long as nine hours and were often accompanied by classical music in the operating room, were credited with saving an untold number of lives.

But in an interview with Dr. William S. Stoney for “Pioneers of Cardiac Surgery” (2008), Dr. Johnson said “the single biggest thing I ever did to lower mortality” was to prescribe the drug allopurinol, which is ordinarily used to inhibit the production of uric acid (high levels of it can cause gout), but which has also been found to improve survival in cardiac patients by improving their capacity for exercise.

Dr. Johnson never shied from controversy. In the mid-1980s, he was criticized for refusing to operate on AIDS patients out of fear that his surgical team might become contaminated by blood. Despite Cold War tensions, he performed heart surgery in Communist Cuba (becoming, by his account, the first American heart surgeon to do so). And he persevered in his defiance of skeptics to prove that multiple bypasses were practical.

Dr. Johnson liked to say that “the best way to prevent coronary disease is to pick your parents,” but he also said that people could take action to prevent it. He himself was eating less meat and more fish, and swimming four times a week, he said in 2014, though he acknowledged that he was a little overweight. (He had also never smoked.)

Most of all he emphasized that surgery was not a cure for heart disease.

“The coronary artery bypass graft operation does nothing for the basic cause of the disease,” Dr. Johnson said, adding, “Prevention is, of course, the ultimate answer.”

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