Sixty Years After Tetralogy of Fallot Correction.

This report describes one of the early cases of open surgical correction of tetralogy of Fallot performed by C. Walton Lillehei and colleagues at the University of Minnesota and discusses findings from the patient's follow-up 60 years later.

Desarrollo histórico de los bypass extra-anatómicos / Historic development of the extra-corporeal bypass

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Bryukhonenko's Autojector: The First Apparatus for Cardiopulmonary Bypass and Extracorporeal Life Support.

Sergey Bryukhonenko was a prominent Soviet physician-scientist who from 1922 to 1924 developed a methodology for perfusing a canine head and keeping it alive using the first extracorporeal life support device he created called "Autojector." From 1926 to 1927, in collaboration with surgeon Nikolay Terebinsky, he performed a series of perfusion experiments of the entire canine body using a more advanced model of Autojector. Subsequently, Bryukhonenko concluded the possibility of extending this methodology to heart surgery. Although Bryukhonenko never applied his device in clinical practice, Terebinsky used the concept from 1929 to 1940 on open heart experiments. Although he never received sufficient acknowledgement for his pioneering work, it must be recognized that Bryukhonenko, along with Terebinsky, laid the groundwork for developing cardiac surgery in the Soviet Union.

A History of Thoracic Aortic Surgery.

Ancient historical texts describe the presence of aortic pathology conditions, although the surgical treatment of thoracic aortic disease remained insurmountable until the 19th century. Surgical treatment of thoracic aortic disease then progressed along with advances in surgical technique, conduit production, cardiopulmonary bypass, and endovascular technology. Despite radical advances in aortic surgery, principles established by surgical pioneers of the 19th century hold firm to this day.

The First Cardiac Operation Using Cardiopulmonary Bypass.

The first open heart operation ever performed was by Clarence Dennis on April 5, 1951, at the University of Minnesota. For several years he had worked developing a heart-lung machine. The operation was on a young girl considered to have an ostium secundum atrial septal defect, but at the procedure a large ostium primum was identified instead. It could not be repaired, and the child died. The anatomic details of this heart have not been previously presented. For historical purposes, the clinical history, intraoperative course, and pathologic details will be discussed and shown.

Surgical Treatment of Acute Massive Pulmonary Embolism.

Massive pulmonary embolism (MPE) is a life-threatening condition. The management of MPE has changed over the course of the last few years. Since the emergence of thrombolytic therapy, only a few patients remain amenable for surgical treatment. Currently, surgical embolectomy is advised only in very specific indications. This chapter will review the background, history, indications, surgical technique and results of surgical pulmonary embolectomy in patients with MPE.

60 aniversario de la primera operación a corazón abierto, con corazón - pulmón artificial, exitosa en Chile y Sudamérica / 60th anniversary of the first open heart surgery using extra-corporeal circulation in Chile and South America

On September 4th, 2017 it will be 60 years since Dr. Helmut Jeager performed the first successful open-heart surgery in Chile and South America on a patient with a congenital heart defect. He performed the closure of an ostium secundum type inter atrial septal defect, using The Wall - Lillehei extracor-poreal circuit. Although in most cases this type of surgery has been replaced by closure through inter-ventional catheterism, at that time the operation had big medical and news media impact. For children born with a congenital heart defect, cardiac surgery meant a before and after. Before, children less than one-year old had a limited survival rate, about 30% at one year. Now, thanks to cardiac surgery the survival is close to 95% and in most cases life expectancy is normal or with only few limitations.

Development of cardiopulmonary bypass ­ A historical review.

The idea of isolated organ perfusion, a precursor of cardiopulmonary bypass, came by Legalois in 1812. First isolated organ perfusion was described by Loebell in 1849. The first closed system for oxygenation and returning the blood through arteries was created by Frey and Gruber in 1885. Gibbon Jr. is considered the father of extracorporeal circulation. In spring of 1934 he began constructing a machine for extracorporeal circulation in Boston. He published the first description of this system in 1937. Gibbon won the grant of the International Business Machines Corporation for developing the machine in 1947. Together they developed Model I in 1949 and Model II in 1951. After a few unsuccessful attempts in 1952, the first successful surgical intervention on the heart (closure of atrial septal defect) using cardiopulmonary bypass was performed on May 6, 1953. In 1945, Kirklin and his working group reported on a series of eight successfully treated patients in a row who underwent surgery with extracorporeal circulation. First successful valve surgery under the direct vision was performed by Dodrill in 1952, using his "Michigan Heart" machine as a right heart bypass. Using cardiopulmonary bypass, cardiac surgeons can deal with the complex cardiac pathology and save millions of lives.

The History of Goal-Directed Therapy and Relevance to Cardiopulmonary Bypass.

Goal-directed therapy is a patient care strategy that has been implemented to improve patient outcomes. The strategy includes aggressive patient management and monitoring during a period of critical care. Goal-directed therapy has been adapted to perfusion and has been designated goal-directed perfusion (GDP). Since this is a new concept in perfusion, the purpose of this study is to review goal-directed therapy research in other areas of critical care management and compare that process to improving patient outcomes following cardiopulmonary bypass. Various areas of goaldirected therapy literature were reviewed, including fluid administration, neurologic injury, tissue perfusion, oxygenation, and inflammatory response. Data from these studies was compiled to document improvements in patient outcomes. Goal-directed therapy has been demonstrated to improve patient outcomes when performed within the optimal time frame resulting in decreased complications, reduction in hospital stay, and a decrease in morbidity. Based on the successes in other critical care areas, GDP during cardiopulmonary bypass would be expected to improve outcomes following cardiac surgery.

History of cardiopulmonary bypass (CPB).

The development of cardiopulmonary bypass (CPB), thereby permitting open-heart surgery, is one of the most important advances in medicine in the 20th century. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how recently it came into use (60 years) and how much the practice of CPB has changed during its short existence. In this paper, the development of CPB and the many changes and progress that has taken place over this brief period of time, making it a remarkably safe endeavor, are reviewed. The many as yet unresolved questions are also identified, which sets the stage for the other papers in this issue of this journal.

A history of innovation: cardiac surgery in Minnesota.

For centuries, the heart was believed to be an inoperable organ. Through the development of new technologies and techniques, the initial difficulties inherent with operating on a moving organ began to fade. But as surgeons in the last century pushed the boundaries of cardiac repair, new problems arose. To solve them, they enlisted the help of physiologists, residents and engineers. By taking a multidisciplinary approach, sharing information and ideas, and working collaboratively, University of Minnesota and Mayo Clinic investigators found themselves at the forefront of cardiac surgery. This article reviews Minnesota's contributions to the field.

A Brief History of Cardiopulmonary Bypass.

The development and application of cardiopulmonary bypass (CPB) to permit open heart surgery is considered among the most important clinical advances in medicine during the last half of the 20th century. The birth of CPB for cardiac surgery is attributed to its first successful clinical use by John Gibbon Jr, 51 years ago but its practical clinical use really began in the spring and summer of 1955 when 2 groups led by John Kirklin at the Mayo Clinic and C Walton Lillehei at the University of Minnesota, initiated the routine use of CPB for open heart surgery. However, considerable developments were necessary and preceded the clinical accomplishment of CPB, and much has followed to make it the remarkably safe and effective procedure that it has become today. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how brief its history is and how much the practice of CPB has changed during its short existence. The aim of this article is to review this fascinating history and the lessons that can be learned from this review, and to indicate the opportunities that still exist for advancement.

Revisiting the Baffes operation: its role in transposition of the great arteries.

Thomas Baffes developed one of the first operations for transposition of the great arteries directing inferior vena cava flow to the left atrium using an interposed homograft in the era before open heart surgery. He performed 117 Baffes operations from 1953 to 1960, with 30% overall mortality, and an additional 85 Baffes procedures before 1968, allowing many to survive until the atrial baffle operations. During the early days before hospitals had cardiopulmonary bypass machines, Tom Baffes and colleagues purchased a heart-lung machine and transported it to various Chicago hospitals to treat patients and stimulate interest in this emerging technology.

A tribute to Dr Willem J. Kolff: innovative inventor, physician, scientist, bioengineer, mentor, and significant contributor to modern cardiovascular surgical and anesthetic practice.

Dr Willem J. Kolff was surely one of the greatest inventors/physicians/scientists/bioengineers of the last few hundred years. He was knighted (Commander of the Order of Oranje-Nassau) in 1970 by Queen Juliana of the Netherlands. In 1990, Life magazine published a list of its own 100 most important figures of the 20th century. Kolff stood in 99th place as the Father of Artificial Organs. Dr Kolff forged a path of innovative thinking and creativity that has had a huge impact on the quality of human life. His contributions to the development of the artificial kidney and dialysis, the heart-lung machine, the membrane oxygenator, potassium arrest of the heart, the AH, mechanical cardiac assistance, and other artificial organs, and his support and mentoring of hundreds to thousands of anesthesiologists, surgeons, and bioengineers throughout the world, have had a significant impact on anesthesiology and the medical community.

Milestones in pediatric cardiology: making possible the impossible.

Pediatric Cardiology as a discipline has been proposed to have been born on August 26, 1938, when Robert Gross at the age of 33 years, successfully ligated a patent ductus arteriosus of a 7 years girl at the Children's Hospital in Boston. In November 1944, Helen Taussig convinced Alfred Blalock to anastomose the left subclavian artery to the left pulmonary artery after Robert Gross had declined to cooperate with her. About the 1950s, at the University of Minneapolis, Clarence Walton Lillehei worked on a controlled "crossed circulation" in which the cardiopulmonary bypass machine was another human, generally one of the patient's parents. In 1966 Williams Rashkind introduced ballon septostomy as a palliative approach to complete transposition of the Great Arteries, followed later by Jean Kan's balloon valvuloplasty to open the pulmonary valve. During the 1960s Giancarlo Rastelli developed a new classification of the Atrio Ventricular Canal defect which allowed to have a strikingly better surgical results. Today, even the hypoplastic left heart syndrome (HLHS), at one time a fatal condition, is operable. The completion of the Human Genome Project has been an enormous help in the understanding the genetic causes of cardiac anomalies. However, there are very few approved application for stem cells, and stem cells will not likely replace organ transplantation any time soon. Recently, the protein survivin has been described as a novel player in cardioprotection against myocardial ischemia/reperfusion injury. The science needs to be made with love to warrant the humanity of Research.