In the interview: Dr. Dilek Gürsoy on artificial hearts

She was the first woman in Europe in 2021 to replace a human heart with a total artificial heart. And at the latest since Dr. Dilek Gürsoy was awarded "Doctor of the Year" in 2019, she has also been by far the most well-known German heart surgeon.

Gürsoy has already recounted her unusual career path from a guest worker child to the top of this royal discipline in her book "I Stand Here Because I'm Good" told. Now, she wants to become the first woman to open a private clinic . And as is often the case with pioneers – especially female pioneers in male domains – there are not only glass ceilings to break through but also plenty of prejudices to overcome, especially in financing such an endeavor.

"If I've learned anything from the many conversations with banks in recent months, it's that I do it alone or not at all. I don't want an investor on board who ultimately interferes with the medical direction."

How far have the preparations for your clinic progressed?

I have already found the right property in Mönchengladbach. I founded the company at the beginning of the year. The whole thing is primarily to be financed through crowdfunding. I am also in talks with some credit institutions.

But these talks are still tough. Many cannot imagine a woman as the entrepreneur of a private clinic. No wonder, as there haven't been any so far. Some fear that I'm planning a one-woman show, even though I've already gathered a great team of specialists around me. It's tedious.

Maybe you just come across as too confident? After all, your biography is titled: “I'm here because I'm good”. Does that scare men?

I have never participated in the typical power games. Neither at the operating table, where it's about the pole position next to the professor, nor in the female variant, voluntary self-exploitation. The fact is, women are better surgeons - if only because they know their limits.

And fortunately, there are now more female chief physicians in the surgical field at university clinics. But all 78 clinics in Germany are predominantly led by men. However, it's not about having a certain title or being the first everywhere for me. I don't need that for my ego.

But I want to have this opportunity as a woman, and above all, I want to help patients to be operated on in the best possible way and to be able to make the necessary decisions themselves. Because I love my job and have many innovative ideas.

How many hearts have you already implanted?

You have to distinguish between human hearts and total artificial hearts. These are two separate clinical areas. I am mainly at home in the artificial heart area. I've certainly implanted thirty total artificial hearts in humans.

That doesn't sound like much, but it's a lot. With left heart support systems, where the actual heart remains in the body and a pump is inserted into the left or right ventricle, I come to over a hundred if you count the animal experiments.

In research, people are currently focusing primarily on mutated pig hearts because there are still too few organ donations. What do you think about that?

That's not entirely new. There have also been experiments with baboon hearts. For me, any kind of research that deals with alternatives to organ donation is important and correct.

However, I believe that artificial heart research is much further along – and would be even further – if we had the money that is rightfully invested in xenotransplantation. In the field of artificial heart research, we are much further along and could make great progress in the foreseeable future with the help of AI. But unfortunately, no money is flowing into this at the moment – especially in Germany.

Maybe it's also because most people don't want a loud, heavy machine instead of their heart? Somehow the heart is sacred...

That's always a matter of perspective. If I'm terminally ill and there's no hope for a donor heart, most people are very happy about such an alternative. Even if it's just a bridge to the actual transplant.

At first, it doesn't matter that the drive weighs a few kilos and the cables end outside the chest cavity. But that's exactly what needs to be further researched scientifically to make this machine smaller and quieter and as fully implantable as possible. The fact is, however, that at the moment only two total artificial heart systems are approved worldwide.

The American and French models. For a while, there was no alternative to the human heart, only the aforementioned American support system. It's a drama. That's why I'm also researching with a team abroad on sheep to develop a new total artificial heart. I firmly believe that this will benefit humanity.

© Peter Rigaud/laif

"For a while, there was no alternative to the human heart," said Dr. Dilek Gürsoy.

Why sheep in particular?

Abroad, there is a particularly large breed that is ideally suited. However, investors require that the sheep survive for ninety days after the implantation with the artificial heart. We cannot achieve that yet, mainly because the animals have a different metabolism and do not tolerate a high dose of anesthesia.

They have to be awakened half an hour after the operation and run around almost freshly operated, including the external pump. It's all difficult to control. A human sleeps for 24 to 48 hours at first and recovers for a few days after such a serious intervention. Nevertheless, I'm convinced that it works if we have the necessary financial resources.

What would be different in your clinic compared to the big hospitals?

On the one hand, my patients would get everything from a single source - almost like a family. With us, an experienced team of specialists takes care of everything from the OR nurse to the anesthesiologist, from the assistant doctor to the cleaning staff, and from the preliminary discussion to the aftercare for those affected. We would offer everything in one house, from prevention to surgical care.

It should not be divided into esoteric knowledge, hierarchies, and only partially assumed responsibility. That actually harms quality and healing. But above all, I have always personally taken care of my patients around the clock.

I am not a surgeon who just operates and goes home; instead, I sit by the bedside, observe the tubes myself, and talk to the relatives. I believe my secret to success is that I accompany people back to life.

Is empathy your greatest healing power?

Empathy and the enthusiasm with which I care for my patients. Maybe it sounds like a cliché, but I really try to touch people's hearts. I notice this in personal conversations with patients who have just had a heart attack, who are insecure, who may be crying.

This closeness, which I can build, does them good and gives them new courage. There are many good surgeons, but at the end of the day, it is important to take away the fear of those affected and to gain their trust. In return, my patients have always taken care of me, recommended me, and promoted me. In the end, I am where I am today because of them.

What role does your origin play?

My mother was and still is my greatest supporter. My Turkish family has always believed in me. I am a worker's child – my mother worked on the assembly line, in shifts. And yet I learned from her the ambition and gratitude to be able to achieve something myself and to want that.

That's why you probably know no snobbery either?

Especially here, where it's a matter of life and death, only the person counts. I treat the guest worker with the same respect as the chairman of the board. Although I am quite aware that, especially in a private clinic, I also depend on some patients paying more than others due to their insurance.

Werden Sie denn sofort auch komplette Kunstherzen in Ihrem Haus operieren?

Nein, am Anfang bieten wir die üblichen kardiologischen Untersuchungen, konventionellen Herzoperationen und Ähnliches an. Doch die Kunstherzforschung wird großen Raum in unserem Marketing einnehmen, und ich habe jetzt schon Kooperationen für die Zukunft geplant.

Vor allem wollen wir in jedem Bereich State of the Art sein. Ich setze voll auf künstliche Intelligenz, wenn es um Bürokratie und zeitgemäße Behandlungsmethoden geht. Von der digitalen Patientenakte bis zu Touchscreens in jedem Zimmer. Auch für die Patienten selbst, damit sie sich ein Bild von der Behandlung oder von Befunden machen können.

Ich rede mit vielen kleinen Start-ups im Health-Bereich, um sie gegebenenfalls zu integrieren. Und Angst vor Instagram habe ich auch nicht. Ich möchte diese Verkrustung der Herzchirurgie auflösen und die Menschen auf allen Plattformen und über Social Media informieren.

Meine Mitarbeiter dürfen nicht nur posten, sie sollen es sogar ausdrücklich. Natürlich in einem engen ethischen Rahmen. Das gehört zur modernen Aufklärung. Und nur so können mehr Menschen davon überzeugt werden, ihre Organe zu spenden.