Cardiac surgery
Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e.g. coronary artery bypass grafting), correct congenital heart disease, or treat valve problems created by various causes including endocarditis.
History
The earliest operations that can be considered cardiac surgery were limited to the pericardium, and were pioneered by, among others, Francisco Romero[1], Dominique Jean Larrey, Henry Dalton, and Daniel Hale Williams. The first successful surgery on the heart itself, performed without any complications, was by Dr. Ludwig Rehn of Frankfurt, Germany, who repaired a stab wound to the right ventricle on September 7, 1896.
It was soon discovered that the repair of intracardiac pathologies necessitated a bloodless and motionless environment, which means that the heart should be stopped and by-passed by use of an extracorporeal circulation technique, hence the term of cardiopulmonary bypass. The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by Dr. C. Walton Lillehei and Dr. F. John Lewis at the University of Minnesota on September 2, 1952. Dr. John Heysham Gibbon at Jefferson Medical School in Philadelphia reported in 1953 the first successful use of extracorporeal circulation by means of a pump-oxygenator, but he abandoned the method, disappointed by subsequent failures. In 1954 Dr. Lillehei realized a successful series of operations with the controlled cross-circulation technique in which the patient's mother or father was used as a 'heart-lung machine'. Dr. John W. Kirklin at the Mayo Clinic in Rochester, Minnesota started using a Gibbon type pump-oxygenator in a series of successful operations, and was soon followed by surgeons in various parts of the world.
Recently, however, doctors have begun to perform "beating heart surgery," a term used to describe cardiac surgey done without the aforementioned bypass pump mechanism. In these operations, the heart is beating during surgery. Some researchers believe this approach results in fewer post-operative complications and better overall results. The Heart Disease Information Center provides a summary of recent work in this area.
External links
- The American Heart Association
- "Congenital Heart Disease Surgical Corrective Procedures" - a list of surgical procedures
- The Heart Disease Information Center
- What to expect before, during and after heart surgery from Children's Hospital Heart Center, Seattle.
- Heart surgery slideshow from Children's Hospital Heart Center, Seattle.zh:心脏外科