The First Cardiac Anesthesiology Fellow, William A. Lell: A Brief History.

Fifty years ago, on August 1, 1971, William A. Lell became the first cardiac anesthesia fellow at Harvard's Massachusetts General Hospital (MGH) Department of Anesthesiology, training with the world's first group of anesthesiologists whose clinical practice, teaching, and research efforts were exclusively devoted to cardiac anesthesia. Lell's early interest in cardiovascular medicine and how mentors, particularly at the MGH, influenced his early career development are recounted. The challenges a young pioneer faced in establishing and maintaining an academic cardiac anesthesia program during the initial and rapid growth of an exciting new subspecialty are described. Dr Lell's experience emphasizes the importance of seizing new opportunities and establishing meaningful working relationships with colleagues based on mutual trust as fundamental to successful career development and research in a new medical subspecialty.

What is in the Dash? An Examination of the Life and Contributions of John B. Flege, Jr., MD.

It is, indeed, a privilege to stand here before you this morning to give the annual Flege Lecture.  Dr. Sande Starnes has kindly supplied me with a list of prior visiting professors, who previously have had the honor to deliver this talk. When we examine the names of those who have been so honored, and note their many accomplishments, I cannot help but remember the words of Winston Churchill, who, when speaking of another person, could well have been speaking of me, when he described "a modest little person, with much to be modest about."

History of Cardiac Anesthesia in New Zealand.

New Zealand has a long and proud history of innovation in cardiac surgery and anesthesia. There have been a number of prominent men and women who have contributed to the development of cardiac anesthesia in New Zealand. There are numerous ongoing challenges in providing cardiac anesthetic services to the population of New Zealand.

History and Current Status of Cardiac Anesthesia in Singapore.

Singapore is a small Southeast Asian island city-state located at the tip of the Malay peninsula with a population of 5.61 million people. It was a former British colony that went on to become a part of Malaysia before gaining independence in 1965. Since then, Singapore has developed tremendously from a small fishing village into the region's medical hub. This article will explore the roots of cardiac anesthesia in Singapore and how it has developed into a subspecialty today.

History and Current Status of Cardiac Anesthesiology in Russia.

Anesthesiology, the branch of medicine concerning anesthesia and management of the vital functions of patients undergoing surgery, has played an important role in the development of cardiac surgery. In the middle of the last century, medical professionals had little experience in the treatment of congenital and acquired heart diseases. Progress of cardiac anesthesiology in Russia, as well as in countries across the globe, was due to requests to increase the safety of surgical procedures and to improve survival rates for the increasing number of patients with complex heart diseases. The development of cardiac surgery and anesthesiology in Russia evolved in 2 directions simultaneously in the mid-1950s. Some surgeons widely accepted the use of perfusionless hypothermia (hypothermia caused by surface cooling without perfusion); others were in favor of cardiopulmonary bypass technology. This review focuses on major historic milestones of cardiac anesthesiology in Russia, including its current status and the major problems it faces today.

Fifteen Years of Transesophageal Echocardiography in Cardiac Anesthesia in Russia.

Transesophageal echocardiography was first introduced in Russia as a component of anesthesiology monitoring in 2003 following its successful implementation in the practice of cardiac anesthesia in the United States and Western Europe. This novel opportunity for perioperative hemodynamic evaluation was enthusiastically adopted at several cardiac surgical clinics despite the presence of critical barriers. The most important of these were the lack of certification programs for anesthesiologists, limited equipment, and a lack of understanding of the responsibility of the anesthesiologist as the coordinator of perioperative therapeutic decisions. Although intraoperative transesophageal echocardiography as a part of the anesthesiology protocol has been introduced in less than 10% of Russian cardiac surgery clinics, a group of interested anesthesiologists has formed over the last 15 years. Both the technical conditions and professional mentality of anesthesiologists need to be changed substantially for successful further development of intraoperative echocardiography. This review aims to highlight the milestones, successes, and challenges in the implementation of intraoperative echocardiography in the practice of cardiac anesthesiology in Russia, which may be interesting to a wide range of cardiac anesthesiologists.

The "Ice Age" in Cardiac Surgery: Evolution of the "Siberian" Method of Brain Protection During Deep Hypothermic Perfusionless Circulatory Arrest.

Deep hypothermic perfusionless circulatory arrest was the first practical neuroprotective technique used for open-heart surgery. It was refined at the Novosibirsk Medical Research Center in Siberia and was actively used from the mid-1950s until 2001.This review describes the development of this technique and its contribution to our understanding of the dynamic changes in human physiology during induced hypothermia for circulatory arrest without extracorporeal perfusion. Deep hypothermic perfusionless circulatory arrest was an important stepping stone in the development of modern approaches in neuroprotection and monitoring during cardiac surgery.

Swan, Ganz, and Their Catheter: Its Evolution Over the Past Half Century.

Jeremy Swan and William Ganz developed their eponymous pulmonary artery (PA) catheter in the 1970s and, in the process, revolutionized measurement of cardiac output, pressures within the left side of the heart, and resistance in systemic and pulmonary circulations. Their invention enabled diagnostic measurements at the bedside and contributed to the birth of critical care medicine; technologic advances preceding the PA catheter generally could not be used at the bedside and required patients to be stable enough to be taken to the catheterization laboratory. Swan and Ganz worked in the same department but had quite dissimilar backgrounds and personalities. This article describes their lives and careers, the state of intensive care before and after their catheter was introduced, and the natural life cycle the PA catheter faced as new, less invasive technology arrived to replace it.

History of Cardiac Anesthesia in India.

Before the 19th century, the heart was considered as a "no-go" area, although minor and superficial procedures were performed in the early 1800s. It was only in the later part of the century that surgical repair of the wounds of the cardiac chambers was attempted. Cardiac surgery came to India in the mid-20th century and the operations performed were minor and extracardiac. Initially, the surgeries were performed at a select few centers located at Mumbai, Vellore, Delhi, Chennai, and Kolkata. The anesthesiologists of an earlier era in India worked with limited facilities, and with their interest and devotion contributed immensely to the growth of the specialty of cardiac anesthesia. The progress was somewhat modest until the 1980s, when it started increasing rapidly and India caught up with the Western world by the turn of century. The progress was seen not only in the clinical field, but also in technology, teaching, and academic fields. This article presents an account of the progress in the field of cardiac anesthesia in India, and highlights the contribution of some of the dedicated anesthesiologists because of whom the specialty has reached the present stature.

Tetralogy Surgery - Back To Baltimore 70 Years Later: Melbourne Heritage and Group Tribute to Juan Comas.

Surgery for Tetralogy of Fallot progressed rapidly from the palliative arterio-pulmonary Blalock-Taussig shunt, introduced in Baltimore 70 years ago, to the "classic" complete transventricular repair technique, with which excellent early results were achieved soon thereafter. However, as duration of follow-up increased, so did the awareness of development of troubling late complications, including severe pulmonary insufficiency, right ventricular dilatation and dysfunction, and tricuspid valve insufficiency, all contributing to increasing incidence of late reoperations, as well as to arrhythmias and sudden death. This realization fueled the initial introduction of the transatrial-transpulmonary repair technique by Kawashima, as well as the subsequent firm establishment of this technique within the framework of an integrated surgical approach by Roger Mee in Melbourne. In turn, Mee's numerous trainees and associates led the dissemination of this approach and provided the impetus for the current wide adoption of a variety of right ventricular and pulmonary valve preservation techniques. In addition to the outstanding surgical results reported by individual centers adopting this surgical strategy, encouraging multi-institutional data are emerging regarding the benefits of these approaches for more favorable early and, most importantly, late outcome. One student and strong proponent of the Melbourne approach was our late colleague and friend Juan Comas, to whose memory this article can serve as tribute.

[More than 50 years' experience in the treatment of patients with congenital heart disease at a Hungarian university hospital]. / Több mint 50 év tapasztalat a congenitalis szívbetegek ellátásában egy magyar egyetemi központban. A CSONGRÁD Regiszter alapadatai.

Improvements in surgical techniques and technical advancements have made possible for several patients with congenital heart disease to grow up to adulthood. It has been decided to create a registry for their more precise treatment. This registry now includes 2770 patients with data on 3043 operations, with almost 30 different diagnoses. The purpose of this paper is to review the facts and the basics leading to the establishment of this registry.

An essay on 35 years of the Society of Cardiovascular Anesthesiologists.

This is an historical account of the accomplishments of the Society of Cardiovascular Anesthesiologists from its founding in 1989 to the present. It is written on the occasion of the 35th anniversary of the founding of this organization. The society accomplishments include providing a means to educate anesthesiologists and others about the perioperative care of patients undergoing cardiac, thoracic, and vascular surgery. The society has led accreditation of transesophageal echocardiography and education in cardiothoracic anesthesia. The society publishes a section within Anesthesia & Analgesia and supports investigation by providing a forum for the discussion of research and funding peer-reviewed projects. The first 35 years of the Society of Cardiovascular Anesthesiologists has been remarkable in all that has been accomplished.

60 and Counting: the history of "the thoracic and cardiovascular surgeon".

The Thoracic and Cardiovascular Surgeon was founded as a scientific journal in 1953, making it one of the oldest publications in this specialty. Bearing the original title Thoraxchirurgie, its first language of publication was German. Although the primary focus lay on thoracic surgery, the concomitantly developing specialty cardiac surgery was also well represented from the start, finally taking over the lead in submissions. After having changed its name to Thoraxchirurgie, Vaskuläre Chirurgie in 1963, it became the official journal of the German Society for Thoracic and Cardiovascular Surgery in 1973. With the language of publication having turned into English in 1979, the final title came into effect. This report gives an overview over 60 years of continued development. The history of this journal illustrates not only the transformations of the surgical disciplines reflected but also those of scientific publishing.

Milestones in surgery: 60 years of open heart surgery.

Long periods of experimental research signify the struggle for the goal to substitute the functions of heart and lungs by a machine. In 1931, John Heysham Gibbon, a young surgeon in Boston began animal experiments concentrating on this task. After almost 20 years he succeeded, in May 1953, he performed the first successful open heart operation using a heart-lung machine in the world in Philadelphia. Almost simultaneously, a team of surgeons around Clarence Walton Lillehei in Minneapolis had the same intentions, yet using a different approach. They applied the method of cross-circulation where a parent of the sick child served as "temporary placenta" like a biological oxygenator. Their first successful operation occurred in March 1954. All over the world, many scientists worked intensely on that subject, but did not succeed. However, these two great personalities, persistent and ingenious, reached the same scientific target with very different methods. Thus, both created the foundation for modern cardiac surgery, which is now performed daily all over the world.

Bernoulli in the operating room: from the perspective of a cardiac surgeon.

The Bernoullis were one of the most distinguished families in the history of science. It was Daniel Bernoulli who applied mathematical physics to medicine to further his understanding of physiological mechanisms that have an impact even in today's high-end medicine. His masterwork was the analysis of fluid dynamics, which resulted in Bernoulli's law. Most important for cardiac surgery, it describes how a centrifugal pump works within an extracorporeal circulation, lays the basis for measuring a gradient over a stenotic heart valve, and explains how to measure the transit time flow within a bypass graft.