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　　外科医生1950年代首次在人类心脏里植入了试验性的人造瓣膜。心脏医学自那以来取得了巨大进展。

　　One of the pioneers in that field is Dr. Albert Starr, who co-invented the heart value - which has extended the lives of millions of people.

　　阿尔伯特.斯塔尔(Albert Starr)是这个领域的先驱者之一。

　　Early start

　　Starr was just 16 when he enrolled¹ at Columbia University in New York during World War II.

　　斯塔尔进入纽约哥伦比亚大学就读时才16岁。

　　At that time, school offered accelerated programs for young men heading off to war.

　　当时正值第二次世界大战期间，学校为将要奔赴战场的男青年开设了速成班。

　　He finished in two years, and by the time he was 22, had completed medical school.

　　他在两年后念完了速成班，22岁从医学院毕业。

　　By then, World War II had ended, but the United States was involved in the Korean War so Starr decided² to become a military doctor.

　　那时，二战已经结束。不过，美国卷入了朝鲜战争，斯塔尔决定当一名军医。

　　"At first, I was a battalion³ surgeon on the front line, getting shot at. And then I was transferred to a mobile army surgical⁴ hospital, a MASH⁵ 8076, and I spent a year there," says Starr. "During that year, I did more than 1000 major operations, just as a young kid. I mean, I was 23 years old."

　　斯塔尔说：“起初，我是前线部队的外科医生，生活在枪林弹雨当中。后来我被调到陆军一个流动外科医院，番号是8076。我在那儿待了一年。那一年里，我做了1000多个大手术。我那时还是个毛头小伙子呢。我是说，我才23岁。”

　　It was a perfect training ground for the future heart surgeon. After leaving the military, Starr moved into the new field of open-heart surgery.

　　对这位未来的心脏外科医生来说，这是个最理想的训练场地。离开军队之后，斯塔尔进入了开心手术领域。

　　New field

　　"But it was very limited in scope because you couldn't take too long to do these operations. It would injure various vital organs, especially the brain," he says. "So we had to develop a mechanical device to imitate the lungs and the pumping action of the heart, the heart-lung machine, and it was that development that allowed the growth of open-heart surgery."

　　他说：“可是我们能使用的时间非常有限，因为你不能花太多时间来做这些手术，它会损伤不同的重要器官，特别是大脑。所以，我们必须研发一种机械装置，模仿肺脏和心脏跳动-- 心肺机。心肺机的面世使开心手术得以发展。”

　　Researchers in Philadelphia developed that machine in the 1950s. It pumped oxygenated blood through the body, giving surgeons enough time to try to correct faulty heart valves, including the mitral valve inside the heart.

　　费城的研究者们1950年代研发了这种机器。它把含有氧气的血液输送到全身，给外科医生足够的时间修补有缺陷的心脏瓣膜，包括心脏里面的冠状瓣膜。

　　"We could put a patient on the heart-lung machine. We could open the left atrium. We could look at the mitral valve. Sometimes we could repair it. If we couldn't repair it, we had no alternative," says Starr. "There was nothing to fall back on, so valvular surgery without an artificial valve - at least as a backup - was a very dangerous game to play."

　　斯塔尔说：“我们能够把一名患者和心肺机连接。我们能打开左心房，看到冠状瓣膜。有时候，我们能够修复它。如果不能修复它，就没有替代方法，无路可退。所以，没有人造瓣膜的瓣膜手术是一个非常危险的游戏。”

　　At the University of Oregon Medical School, Starr got a visit one day from an eccentric engineer named Lowell Edwards. An inventor with many patents to his name, Edwards offered hope for a solution.

　　在俄勒冈大学医学院，有一天斯塔尔接待了一位性格古怪的工程师，他叫洛厄尔.爱德华兹。爱德华兹是个拥有许多专利的发明家，他为解决问题带来了希望。

　　Inventive partnership⁶

　　"He was a strange character, but I found out he was a great inventor, with a tremendous reputation. He had retired⁷ and had a lot of time on his hands and he wanted to develop an artificial heart."

　　斯塔尔说：“他是个怪人。可是我发现他是个了不起的发明家，名声远扬。他退休了，有大把的时间。他想发明一个人造心脏。”

　　Starr convinced Edwards to narrow his focus and help develop a mechanical replacement⁸ for the heart's mitral valve, which controls blood flow within the heart.

　　斯塔尔说服爱德华兹缩小他的研究范围，集中精力，研发一个代替心脏冠状瓣膜的机械装置。冠状瓣膜控制心脏里的血液流动。

　　The pair employed the latest space-age materials - Dacron, which was already used in heart grafts⁹, as well as Teflon and a flexible silicone called Silastic. Their device consisted of a ball inside a cage that moved back and forth¹⁰, in turn allowing the blood to flow inside or blocking it. The physician experimented with dogs and solved successive problems, from suture leaks to blood clots¹¹.

　　他们两人采用了最先进的太空时代材料 -- 达克隆。达克隆当时已经在心脏移植手术中使用。他们还采用了特氟隆和一种有弹性的硅胶，叫作硅橡胶。他们的装置含有一个在前后活动的笼子里的球体，交替让血液流入或者堵住血液流入。医生用狗来试验，解决了缝合、血栓等一系列问题。

　　Starr says he and Lowell also encountered non-surgical challenges as they moved through uncharted territory.

　　斯塔尔说，他和洛厄尔在这片处女地探索的过程中也遇到一些非外科手术方面的挑战。

　　"We had to design everything, including the ethical¹² elements, financial, clinical. We attacked one at a time, so the first thing we had to decide was, when we do our first human implant¹³?"

　　“我们得设计一切事情，包括伦理因素、财务、临床。我们一次攻一个问题。我们必须解决的第一件事就是，我们什么时候做第一次人类植入手术。”

　　Using heart valve in humans

　　As the laboratory test dogs survived longer and longer, Starr found himself doing human surgeries sooner than he expected.

　　随着实验室里接受手术的狗存活得越来越长，斯塔尔发现他在人体进行手术的时间比预期来得早。

　　"The chief of cardiology visits the animal laboratory and sees all these healthy dogs with mitral valve replacements¹⁴. And actually one of them sticks his head through the cage and licks his hand. Meanwhile, he's got a hospital full of patients in oxygen tents that need mitral valve replacement, and he said, 'You can't wait on this. We've got patients that need this device.'"

　　斯塔尔说：“心脏学主任参观了动物实验室，看到那些换上冠状瓣膜的狗都健康。甚至还有一条狗从笼子里伸出头来舔他的手。在这同时呢，医院吸氧室里挤满了患者，他们需要替换冠状瓣膜。于是他说，‘你们不能再等了。我们有患者需要这个装置。’”

　　Because Starr was operating on patients with terminal heart disease, there were many failures along the way. The first patient to receive a mitral valve implant, a woman in her 30s, died when an air bubble formed inside her heart. By the early 1960s, however, many of Starr's artificial mitral valve patients were successfully resuming their lives.

　　因为斯塔尔是为晚期心脏病人做手术，所以一路走来有许多失败的病例。第一个接受冠状瓣膜移植的是一名30多岁的妇女。她心脏里形成的一个气泡要了她的命。不过，到1960年代早期，斯塔尔医生的人造冠状瓣膜替换术挽救了许多患者的生命。

　　Today, hundreds of thousands of patients have had this type of implant, either the Starr-Edwards valve design or refinements¹⁵ on that model. Thousands of Starr's former patients send him updates through the social networking Internet site Facebook.

　　今天，数以十万计的患者做了这种手术，要么用斯塔尔-爱德华兹设计的瓣膜，要么用这种模式的改进型。斯塔尔从前的数千名患者通过脸书(Facebook)向他报告最新情况。

　　Starr no longer does surgery, but is active as a medical consultant¹⁶, researcher and teacher. He looks back on the great strides in cardiac surgery over his six decades of practice - refinements in artificial heart valves, dramatic transplant operations and the widely used procedure of heart bypass surgery - proud to have played a part in developing techniques that have extended so many lives.

　　现在，阿尔伯特.斯塔尔不再做外科手术了。不过他仍然活跃在医疗咨询、研究和教学领域。回首60年，心脏外科手术取得了巨大进步，人造心脏瓣膜不断改进提高，重大的器官移植手术成为可能，心脏搭桥手术广泛使用。他为自己在研发他所说的延续了千百万人生命的技术当中发挥了作用而感到骄傲。

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