Our thanks to Frank Ing, MD, MSCAI, for the following tribute to his long-standing friend and colleague Charles E. Mullins, MD, MSCAI.

 


 

Chuck Mullins is arguably the grandfather of the field of pediatric interventional cardiology. During his illustrious career that spanned four decades, Chuck made innumerable contributions to our field. He pioneered the transseptal puncture techniques for left heart catheterizations using the Mullins long sheath. He was one of the original Cardioseal investigators for ASD occlusions, as well as device trials for Rashkind PDA occluder. Even the famous Krichenko classification for PDA morphology actually came from Chuck. He first reported on the use of stents to treat congenital heart disease back in the late 1980s which resulted in an explosion of the pediatric interventional field. Chuck was a perfectionist in the cath lab whether in obtaining accurate pressure waveforms; taking perfect angiograms; or positioning stents precisely. To date, the worldwide standards of stent implantation techniques and post-stent management protocols for CHD originate from his experience. Chuck was a creative innovator and master of his craft. Because most cath lab supplies and cardiac devices are not FDA approved for children, Chuck knew how to modify wires, sheaths, and catheters to fit the unusual anatomy of the deformed hearts in infants and children. He often MacGyvered his way through the most complex and challenging of cases. His innovations have truly shaped and guided our modern approach to CHD interventions.

Chuck was the first pediatric cardiologist to participate in the SCAI annual conference back in 1987 in Orlando. He joined the cath lab standards committee and authored much of the standards for the pediatric lab in those early days. He continuously encouraged other pediatric interventionists to join SCAI. I recall going to the SCAI meeting in Colorado Springs back in 1996 (at Chuck’s urging) and being in a room of about 20–30 pediatric interventionists. What a contrast to today’s large conference halls with hundreds of pediatric interventionists gathering from all over the country.

Once when asked what was his greatest contribution to the field, Chuck said, training the fellows. Chuck is a gifted teacher and educator and has trained generations of pediatric interventional fellows who have gone on to become directors of other pediatric cath labs and chiefs of pediatric cardiology divisions. Many of us who had the privilege of being trained by Chuck continue to think like Chuck in the cath lab and to make decisions like Chuck; in essence, how to cath like Chuck. Not only do we teach his techniques to our trainees, some of us have even taken on some of his mannerisms. Chuck had many well-known sayings that to this day, his former fellows can recall vividly such as echo schmecho, or if you push the catheter 3 times and it didn’t work, the fourth time still won’t work, so change the catheter or the catheter pusher or if you don’t know what’s going on, take a picture. My favorite was, get to the edge, just don’t fall over. When I graduated, I asked Chuck for a departing word of wisdom and his reply was, don’t kill anyone during your first year. That was an honest and true answer and one that I share with graduating fellows. During his heyday, Chuck had a constant entourage of international professors visiting and learning from him in the cath lab, and many returned back to their countries to start their own congenital heart disease interventional programs.

While Chuck holds the highest standards for his profession and his cath lab skills are legendary, he is also a man of humility and is satisfied by simple pleasures such as a good beer and good conversation with good friends. I’ve witnessed that for almost 30 years since training with him in 1993. He never let his fame and celebrity status define his ego. I recalled meeting him for the very first time at a conference as a cardiology fellow. After his lecture, I waited in the background for the crowd to greet him and finally approached him at the end to introduce myself. By then, the room had emptied out but we spoke for another twenty minutes. That encounter forever changed how I interact with students and trainees, never dismissing them as unimportant. This is a common story among those who know Chuck for he always had a way of making one feel like he or she is part of his family. Through the years, we have all witnessed Chuck’s generosity of his time and legacy of giving to patients, fellows, colleagues, and the community of interventional cardiology.

Chuck’s dedication to the field is unmatched. Even after retirement, he continued to work. He wrote a book on cath lab techniques for CHD interventions. It was over 1,000 pages and it was a single-author book. He spent many more years afterward collaborating with a geneticist and working in two primate labs developing a novel model to inject a vector virus for gene therapy into the liver of baboons and rhesus monkeys. He often invited fellows to join him.

Chuck is the consummate physician, teacher, innovator, mentor, and friend to the pediatric interventional community and deserves to be a member of SCAI’s Legends of Cardiology.