50 años de cirugía de bypass coronario, meditar el pasado, enfrentar el presente y forjar el futuro / Fifty years of coronary artery surgery

Al cumplirse este año 50 años de la cirugía de bypass coronario, introducida y desarrollada por René Favaloro en la Cleveland Clinic, es conveniente meditar el camino seguido previamente por la cirugía para tratar la enfermedad coronaria, analizar cómo la cirugía enfrenta en la actualidad esta grave y frecuente enfermedad, y, si es posible, predecir el rol que ésta jugará en el futuro en el tratamiento de la enfermedad coronaria.

This year is the 50th anniversary of Coronary Artery Bypass Graft surgery, introduced and developed by René Favaloro at The Cleveland Clinic. The occasion calls for meditation about the path followed by surgery to treat coronary artery disease in the past, to analyze how surgery currently faces this serious and frequent disease and, if possible, to predict the role that surgery will play in the future in the treatment of coronary artery disease.

60 años de cirugía de la válvula mitral: Una historia de exploradores, pioneros, héroes y conquistadores de nuestros tiempos / Sixty years of mitral valve surgery

On June 10, 1948, Charles Bailey, MD, operated successfully a mitral valve stenosis in Philadelphia and six days later, Dwight Harken, MD, performed the same operation in Boston, marking the onset of cardiovascular surgery. These successful operations were preceded by several failures and even deaths, that had to be overcome by both pioneers. This manuscript reviews several cases and situations that these surgeons had to face during the development of cardiovascular surgery, that changed the natural history of cardiac diseases. The history culminates with the successful mitral valve replacement, performed by Albert Starr using a mechanical valve designed by him and Lowell Edwards, a retired engineer whose primary interest was to develop an artificial heart. The first mitral commissurotomy in Chile was performed by Svante Tornvall, MD, and Pedro Uribe, MD, at van Buren Hospital in Valparaiso in December, 1950. The first mitral valve replacement was performed by Hugo Salvestrini, MD, in 1964 at the Catholic University Hospital (Rev Méd Chile 2009; 137:1253-60).

Aneurisma do ventrículo esquerdo em paciente com lupus eritematoso sistêmico: relato de caso / Left ventricular aneurysm in a patient with systemic lupus erythematosus: case report

Descrevemos o caso de uma paciente do sexo feminino, de 36 anos de idade, portadora de lupus eritematoso sistêmico, que sofreu infarto do miocárdio e, posteriormente, desenvolveu aneurisma da parede inferior do ventrículo esquerdo e insuficiência cardíaca. A paciente foi tratada cirurgicamente com bons resultados. A raridade dessa condição é realçada.

Introdução à história da cirurgia cardíaca em Minas Gerais, Brasil / Introduction to the history of cardiac surgery in Minas Gerais, Brazil

O objetivo deste trabalho é registrar o início da cirurgia cardíaca em Minas Gerais. Tendo participado dessa história desde o começo, o autor introduz o leitor aos primeiros momentos da realização e aos primeiros nomes que se empenharam na criação e no desenvolvimento dessa especialidade. O resultado são numerosas equipes de qualidade e a segurança oferecida aos pacientes que necessitam dessa assistência. Conclui-se que mais não se fez porque as dificuldades inerentes a todo início de processo restringiram o maior crescimento.

The aim of this is to register the beginning of the heart surgery in Minas Gerais state. Participating from the beginning, the Author has introduced the reader to the fist moments of its accomplishments and the first names that endeavored their efforts in the creation and development of this specialty. It resulted in numerous teams of high quality professionals and security offered to patients that needed their assistance. We conclude that more has not been done because of the difficulties inherent to all beginnings and have restricted its bigger growth.

A history of cardiology in Jamaica

The history of cardiology in Jamaica is conveniently considered in decades beginning in the 1950s. The decade of the 1950s was characterized by early descriptions of the pattern of cardiac disease in adults and children in Jamaica, the establishment of a cardiac clinic at the University Hospital of the West Indies and early cardiac surgical landmarks. Extensive preparatory experimental work in the canine laboratory with respect to cardiopulmonary bypass in the early to mid-1960s culminated in the successful completion of the first open heart surgical procedure in April, 1968. Cardiac catheterization was also increasingly developed in the decade of the 1960s. A highlight of the decade of the 1970s was the establishment of the Heart Foundation of Jamaica which began contributing greatly to preventive cardiology in Jamaica by providing a variety of programmes of prevention. In the decade of the 1980s, non-invasive cardiac diagnostic facilities in Jamaica were considerably enhanced by the introduction and development of echocardiography, treadmill exercise testing and ambulatory electrocardiography. In addition, the very important National Rheumatic Fever prevention programme was established. The cardiac catheterization laboratory was re-opened in the 1990s, thus allowing the performance of coronary arteriography in Jamaica for the first time, and interventional cardiology procedures soon followed. The Jamaica Foundation for Cardiac disease was also established in this decade. The vision for the new millennium of [quot ]A heart healthy Jamaica in the 21st century[quot ] is achievable, but will require appropriate emphasis on expanded preventive and curative cardiology programmes

Cincuentenario de la máquina corazón-pulmón Un relato acerca de los pioneros y héroes y de las circunstancias que llevaron al gran invento que permitió el tratamiento y la cura de las enfermedades del corazón / Fifty years of the heart-lung machine. The report about the pioneers and heroes and about the circumstances that elevated the great invention, which allowed the treatment, and in many cases, the cure of heart illnesses

In 1953 DNA was discovered and the Everest was conquered but also a great invention was developed: the heart-lung machine, which allowed the treatment, and in many cases, the cure of most cardiovascular illnesses. In fact, on May 6, 1953 John Gibbon crowned with success the work of his entire life closing for the first time an atrial septal defect in a young woman using a heart-lung machine of his own invention. Before that, surgeons had explored other roads like hypothermia, cooling the patient in a cold water tub and then rapidly performing the surgical correction of a heart malformation. After his first success, the following 4 patients of Gibbon died, which led him to abandon heart surgery and produced a generalized pessimism about extracorporeal circulation. However, a year later Walton Lillehei reverted this situation with the introduction of controlled cross-circulation in which a patient, usually a child, was connected to a "donor", usually his father or mother, whose heart and lung served as a pump and oxigenator, allowing the performance of open heart surgery. Finally, it was Lillehei again who a year later introduced the bubble oxigenator, simple and inexpensive, opening the doors of open heart surgery to all surgeons around the world. For this, and many other reasons, Walton Lillehei is considered by most surgeons as the "Father of Open Heart Surgery". Lillehei visited Chile in 1963 and operated on a patient in the surgical theaters of the Hospital Clínico de la Universidad Católica and was named an Honorary Member of the School of Medicine of this University. Before that, in 1957 Helmut Jaeger at the Hospital Luis Calvo Mackenna performed the first successful surgical closure of an atrial septal defect with extracorporeal circulation in Chile using a De Wall-Lillehei bubble oxigenator (Rev Méd Chile 2003; 131: 1337-44).

Y de cómo se llegó finalmente a la cirugía a corazón abierto: un relato en 2 partes de pioneros, héroes y conquistadores del siglo pasado: parte II / How open heart surgery became a reality: a tale of pioneers, heroes and conquerors of the last century: part II

En la primera parte de este relato se dio cuenta de cómo los cirujanos, con perseverancia e imaginación, logran diseñar procedimientos quirúrgicos correctores para patologías extracardíacas y procedimientos paliativos para patologías intracardíacas, estableciendo la cirugía cardiovascular como una especialidad propiamente tal. En esta segunda parte revisaremos primero la etapa de la cirugía cardíarca cerrada, en especial la cirugía de la esteneosis mitral, destacando siempre la circunstancias que rodearon a estos cirujanos y las adversidades que debieron afrontar, para llegar finalmente a la cirugía de corazón abierto con circulación extracorpórea, como la conocemos en la actualidad, para lo que previamente fue necesario pasar por la cirugía cardíaca con hipotermia y luego con circulación cruzada controlada, en la que un "donante" humano sano, habitualmente el padre o la madre de un niño, servía como oxigenador

Y de cómo se llegó finalmente a la cirugía a corazón abierto: un relato de pioneros, héroes y conquistadores del siglo pasada: parte I / About the arrival of open heart surgery: a pionners, heroes and conquerors of last century report: part I

La cirugía a corazón abierto, como la conocemos en la actualidad, es un logro del siglo recién pasado. Hasta fines del siglo XIX el corazón era considerado un órgano inasequible y prohibitivo a la cirugía, hasta que en 1896 Ludwing Rehn sutura por primera vez, con éxito, una herida de corazón. En los primeros años del siglo XX la cirugía se limita, con éxito relativo, al tratamiento de las heridas de corazón y luego de las afecciones pericárdicas, hasta que en 1938 Robert Gross liga con éxito un ductus arterioso persistente, operación que se convierte en la chispa que enciende la explosión de la cirugía cardiovascular, a partir de la cual rápidamente se avanza hasta conseguir un tratamiento quirúrgico corrector de la coartación aórtica, para luego desarrollar procedimientos paliativos extracardíacos para malformaciones intracardíacas, como la estenosis pulmonar