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Early Heart Surgery
Before the first open heart surgery could take place, many attempts at working on the heart in general needed to be conducted. Prior to the 1940s, very few successful surgeries on the heart took place. The only successful operations were those conducted on parts of the heart that had been compromised from things like stab wombs. However, with the onset of World War II, doctors were given new opportunities to attempt surgeries in emergency conditions and repair damages. This fact was aided by new advancements in facilitators that helped make the process work, such as blood transfusions, anesthetics and antibiotics.
One pioneer in early heart surgery was Dr. Dwight Harken, a U.S. Army surgeon, who developed a technique to remove shrapnel from the hearts of injured soldiers. He simply cut into the wall of a beating heart, inserted a finger and removed shrapnel. All of his patients survived. Through his work, the concept of closed heart surgery took hold in hospitals around the world.
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Development of Open Heart Surgery Techniques
While Harken's technique was beneficial to many patients, it could not be used to address more serious conditions such as congenital heart disorders or narrowed heart valves caused by rheumatic fever. This meant that some form of surgery needed to be created that would allow physicians to open the chest cavity without making the patient bleed to death. The main problem was that stopping a person's heart only gave surgeons four minutes to operate, otherwise the deoxygenization of the blood would result in brain damage.
Dr. Bill Bigelow of the University of Minnesota came up with a solution based on observations he had made about ground hogs. During his studies in the cold Canadian climate, he noticed that the animal would hibernate through winter. The animals' hearts would slow and they could survive for months of time without eating. He assumed that the cold had something to do with this survival skill. At first, he began to experiment with dogs, lowering their body temperatures and performing open heart surgery. Bigelow found that the surgeries could last much longer than four minutes and the dogs would survive. This proved his theory that cold temperatures caused brain and body tissues to need less oxygen.
Above left: Open Heart Surgery. (Supplied by the National Institute of Health; Public Domain; http://upload.wikimedia.org/wikipedia/commons/0/05/Coronary_artery_bypass_surgery_Image_657B-PH.jpg)
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The First Open Heart Surgery Performed on a Human
The first open heart surgery conducted on a human patient occurred on September 2, 1952. Two surgeons from the University of Minnesota, Dr. Walton Lillehei and Dr. John Lewis, performed the procedure on a fiver-year-old girl with a hole in her heart. The doctors used a specialized blanket that lowered her body temperature to 81 degrees Fahrenheit. However, her body continued to shiver, disrupting the ability of the surgeons to perform their duties. To mitigate this problem, they gave her anesthesia, giving them roughly ten minutes to perform the operation. Lillehei and Lewis opened up her chest, clamped the inflow to her heart and allowed it to empty of blood. They cut the open the girl's heart and sewed up the hole. The heart was repaired and the girl was immersed in a warm water bath, bringing her temperature back to normal. The girl survived the procedure with no side effects and the first open heart surgery was a success, opening up the concept to new procedures and methods.
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"Pioneers of Heart Surgery" NOVA: http://www.pbs.org/wgbh/nova/heart/pioneers.html
"50th Anniversary of First Open Heart Surgery" University of Minnesota: http://www.cuttingedge.umn.edu/cuttingedge2001/fall2001pg2.htm