RESUMEN
A pioneering surgeon at the University of Minnesota, Dr C. Walton Lillehei, is still considered the "father of open-heart surgery". Dr Lillehei and his surgical team performed the first open-heart operations utilizing cross-circulation, including the first successful ventricular septal defect closure on a 3-year-old boy. Before his death at age 67, this patient arranged to donate his body to the University of Minnesota's Anatomy Bequest program. We describe this patient's medical history, and present unique images of internal/external cardiac anatomies and implanted devices obtained via direct visualizations, computed tomography, and fluoroscopy post-mortem. Additionally, we present computational models and 3-dimensional printed models.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/historia , Circulación Cruzada/historia , Defectos del Tabique Interventricular/historia , Defectos del Tabique Interventricular/diagnóstico por imagen , Defectos del Tabique Interventricular/cirugía , Historia del Siglo XX , HumanosRESUMEN
Between March 26, 1954 and July 19, 1955, C. Walton Lillehei and colleagues operated upon 45 infants and children with previously uncorrectable cardiac anomalies using cross-circulation with a human donor. Late follow-up was obtained in all of the 28 patients discharged after the operation. All of the 20 currently living patients were personally interviewed with regard to their cardiac status. Eight early survivors have died. Three died after repair of a residual cardiac anomaly. Another died 4 months postoperatively from heart failure. The other 4 died 13 to 47 years later: 2 of unknown causes, 1 of pneumonia, and 1 was an accident. Eleven late cardiac operations were performed. Seven were done to correct a residual anomaly. More than 40 years later, 2 patients underwent procedures to correct tricuspid regurgitation. One had a mitral valve procedure, and another underwent coronary artery bypass grafting. Of the current 20 survivors, none is limited from cardiac causes. Considering that these 45 patients represent "the dawn of open-heart surgery," the long-term results are quite remarkable.
Asunto(s)
Circulación Cruzada/historia , Circulación Cruzada/métodos , Circulación Extracorporea/historia , Circulación Extracorporea/métodos , Cardiopatías Congénitas/historia , Cardiopatías Congénitas/cirugía , Complicaciones Posoperatorias/etiología , Sobrevivientes , Adolescente , Adulto , Causas de Muerte , Niño , Preescolar , Estudios de Seguimiento , Cardiopatías Congénitas/mortalidad , Historia del Siglo XX , Historia del Siglo XXI , Mortalidad Hospitalaria , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Minnesota , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/cirugía , Reoperación , Estudios Retrospectivos , Análisis de Supervivencia , Adulto JovenRESUMEN
At the 50th Anniversary of Open Heart Surgery symposium sponsored by the Lillehei Heart Institute of the University of Minnesota in October 2004, the following pioneers in open heart surgery development presented papers of historical interest: Drs. Peter Agre, Robert W. Anderson, William Baumgartner, Alain Carpentier, Aldo Casteneda, Randolph Chitwood, Jr., Denton Cooley, Fred Crawford, Michael DeBakey, Richard DeWall, Vincent Gott, Claude Lenfant, Floyd Loop, James Holler, Glen Nelson, Norman Shumway, Manny Villafana, Richard Weisel, and Sir Magdi Yacoub.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/historia , Circulación Cruzada/historia , Procedimientos Quirúrgicos Cardíacos/métodos , Historia del Siglo XX , HumanosRESUMEN
This paper is a brief biography of two of the most important contributors to the development of open heart surgery. In 1952, John Lewis performed the first successful open heart surgical procedure of any kind, repairing an atrial septal defect under general hypothermia in a 5-year-old girl. In March 1954, Walt Lillehei, utilizing controlled cross circulation, embarked on a series of 45 consecutive patients. The bubble oxygenator appeared in 1955, and open heart surgery was introduced to many of this nation's major medical centers.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/historia , Circulación Cruzada/historia , Historia del Siglo XX , Humanos , Oxigenadores/historia , Estados UnidosRESUMEN
The development of open-heart surgery has been reviewed beginning with general body hypothermia and inflow stasis, then continuing with extracorporeal circulation by controlled cross-circulation. The successes with the latter technique stimulated rapid development of the simple disposable highly effective bubble oxygenator for extracorporeal circulation to permit correction of virtually all forms of congenital and acquired heart disease. For the few conditions not amenable to corrective procedures, heart replacement became a practical reality. The creation of chronic heart block in the early operations had a very deleterious effect upon survival until highly effective electrical pacing was developed.