The Dodrill Pump

Forrest Dodrill and colleagues used a mechanical blood pump on a forty-one-year-old man on July 3, 1952. The pump had been developed in conjunction with engineers at General Motors. It was used to substitute for the left ventricle, the heart's main pumping chamber, for fifty minutes while an attempt was made to repair a defective heart valve. This was the first time the human left ventricle had been successfully bypassed. For his first human patient, Dodrill...

Cary W Akins MD

Clinical Professor of Surgery Harvard University Visiting Surgeon Massachusetts General Hospital The most dreaded complication of coronary artery bypass grafting, other than death, is the occurrence of stroke during the surgery. Unfortunately, as the average age of patients having bypass surgery has risen during the past twenty years, so has the chance of having a stroke. For patients less than age fifty years, the risk of stroke after coronary artery bypass grafting is less than 1 percent for...

Lilleheis Cross Circulation

The heart-lung machine, in its various forms, was not considered the only practical way to bypass the circulation. A young surgeon named Dr. C. Walton Lillehei and colleagues at the University of Minnesota studied a technique they called cross circulation, which did not use a bypass machine at all. Using this technique, the cir Dr. Clarence Crafoord started a research team in Sweden that worked toward developing an open-heart program. However, he became best known for a pioneering operation...

The Roller Pump

Work on the heart-lung machine, he turned to a pump developed by Dr. Michael DeBakey while DeBakey was still a medical student at Tulane University in New Orleans. In those early days, DeBakey worked as a technician in the medical lab and remembered his first exposure to blood pumps I didn't get paid very much, but I liked the work. The faculty member I was working with wanted a pump in the laboratory because he was interested in the pulse wave so he asked me to get a pump for him. I went to...

The Future in Artificial Heart Technology

Stephen Westaby, B.Sc., M.S., F.R.C.S. Oxford Heart Centre John Radcliffe Hospital Oxford University Oxford, England CURRENTLY, THERE ARE more than three million heart failure patients in the United States, with more than four-hundred thousand new cases every year. Treatment of heart attack has come a long way. Today, physicians are able to use clot-busting drugs and catheters to save thousands of lives. There is, however, an unfortunate consequence of this rapid advance. Some of these people...

Safe Tests during Pregnancy

If there are concerns about heart disease based on symptoms or physical findings, diagnostic tests may be performed that are safe for the developing fetus. An electrocardiogram can diagnose abnormal heart rhythm. A twenty-four-hour monitor or loop recorder over weeks may detect an abnormal heart rhythm. A chest x-ray can be performed with proper shielding to protect the fetus. The most useful test is cardiac ultrasound, or echocardio-graphy, which provides information with regard to cardiac...

Fig

The heart's beat is caused by an electrical impulse that travels from the S-A, or sinoa-trial, node to the A-V, or atrioventricular, node and through the specialized heart muscle. Means the heart is contracting. It usually means the ventricles are contracting, but it can also refer to atrial contraction. The portion of the cardiac cycle in which the heart is relaxed.

Risk Factors for CABG in Women

When comparing men and women, several factors have been examined to determine the outcome after surgery. These include age the presence of risk factors like diabetes, hypertension, and renal failure body size as it relates to the size of the blood vessels (especially the coronary arteries) and race (Caucasian or non-Caucasian). Age Because women develop coronary artery disease later than men, women undergoing CABG are often older than men undergoing CABG. For example, although the average age...

Cant We Just Eat a Healthy Diet to Prevent Heart Disease

Some physicians argue that we do not have to use alcohol to prevent CAD because we know other ways (changes in lifestyle habits) that will prevent heart disease lose weight and change your diet. But they do not often appreciate how difficult it is for someone to lose 10 to 20 pounds (and keep it off) or how difficult it is for people to permanently adopt a very low-fat and low-cholesterol diet. Further, our data suggest that the moderate use of alcohol reduces the risk of CAD to a greater...

James L Cox MD

Professor and Chairman Cardiovascular and Thoracic Surgery Surgical Director Georgetown University Cardiovascular Institute Georgetown University Medical Center Washington, D.C. IRREGULARITIES OF THE heartbeat (cardiac arrhythmias) are the most common maladies affecting the heart. Because the heart does not pump blood as efficiently when it has an irregular heartbeat, patients with cardiac arrhythmias usually complain of tiredness and shortness of breath, especially with physical exertion. More...

Heart Valve Problems

PICTURE A RED BLOOD CELL TRAVeling through the venous system toward the heart. It enters the heart through one of two major veins, either the superior vena cava or the inferior vena cava, and passes into the right atrium. The one-way tricuspid valve opens, and the cell flows into the right ventricle. The tri-cuspid valve is composed of three leaflets that are connected on their underside (right ventricle side) to string-like structures called chordae tendineae, which are connected to muscles...

James Marsh MD

Professor of Medicine and Chief, Division of Cardiology Wayne State University IN MOST CASES, HEART ATTACKS are caused by atherosclerosis, which slowly narrows the coronary arteries, and a blood clot that suddenly forms and blocks off the coronary artery completely, thus limiting blood flow to the heart. When a patient comes into a hospital emergency room early in the course of a heart attack, physicians may administer a clot-dissolving drug. The most common clot-dissolving drug is tPA (tissue...

Heart Attack and Heart Failure

The medical term for heart attack is myocardial infarction. During a heart attack, a portion of the heart muscle dies. Patients usually survive small heart attacks. If the heart attack involves a significant portion of the heart, however, the victim will usually die due to arrhythmias during the beginning of the heart attack. In the event a patient survives a large heart attack, a considerable portion of heart muscle will turn into scar tissue and no longer contract. This can lead to heart...

What is Cardiac Catheterization

CATHETERS ARE FLEXIBLE, HOLlow tubes (originally rubber, but now advanced plastic) that are threaded through an artery or vein into the body. They are able to travel from the insertion site in the groin or arm into major arteries and veins, heart chambers, and even the brain. Although cardiac catheteriza-tion is primarily diagnostic and not considered heart surgery, it is an invasive procedure that in some cases has replaced open heart surgery. These devices have a wide variety of uses,...

Pregnancy in the Woman with Heart Disease

Before becoming pregnant, a woman may have a congenital heart defect or acquired heart disease. Many congenital defects can now be surgically repaired in infancy, and the first generation of these patients has only recently reached childbear-ing age. They represent a new kind of patient for obstetricians and cardiologists. Acquired heart disease in pregnant women includes primarily rheumatic disease involving heart valves, heart failure, and coronary artery disease. Because many women are now...

Patrick M McCarthy MD

The Cleveland Clinic Foundation Department of Cardiothoracic Surgery Cleveland, Ohio For decades heart surgeons have opened the left ventricle to reconstruct the damaged heart muscle. This has typically been used for cardiac aneurysms, or areas of scarred heart muscle that bulge out when the heart contracts and cause heart failure, blood clot formation, and heart rhythm problems. In recent years, this operation has been extended beyond classic aneurysms to include patients who have damaged...

Alcohol and Breast Cancer

Although many studies have shown that breast cancer rates are higher among heavier drinkers, a number of research reports suggest that only a small increase in risk begins to appear among women who normally consume just one or two drinks per day. This is not found consistently in all studies. At our institute at Boston University, we have completed a study of wine, beer, and spirits as they relate to breast cancer by using data from the Framingham Study that has been Although all alcohol shows...

The First Coronary Artery Bypass Surgery

DUDLEY JOHNSON, WHO was one of a handful of doctors who popularized the modern coronary bypass operation, first knew he wanted to practice medicine while in seventh or eighth grade but he didn't know he wanted to be a surgeon until he got into medical school. And then I didn't really have any illusions about being a heart surgeon, Johnson said in a 1999 interview. But I figured if I had experience in the chest, I could get a little better job in a clinic somewhere, so I also trained to do...

The Coronary Bypass Operation and Recovery

Graft procedure is still the gold standard for patients suffering from left main or multiple coronary artery disease. The final determination that a coronary artery bypass graft operation is necessary is usually obtained from cardiac catheterization using coronary angiography. If the degree of blockage warrants surgery, a standard battery of tests is performed before surgery. These tests can be done on an outpatient basis and typically include an electrocardiogram, routine blood work studies,...

Retrograde coronary perfusion catheter A

Catheter that is inserted through the right atrium into the coronary sinus, a vein that drains the heart itself. This catheter is usually used to administer cardioplegia solution. rheumatic fever Usually associated with streptococcus infections, although not actually an infection itself. It usually comes on weeks after the infection and may be an allergic reaction to the infection. It can affect the heart, the heart valves, the joints, and the nervous system. rheumatic heart disease...

How Does TMLR Work

No one has yet determined how the laser treatment improves symptoms and the blood supply transmyocardial laser revascularization to the heart. It was initially thought that the holes created by the laser infuse the heart muscle with a new blood supply directly from the heart cavity (such a system exists in animals such as crocodiles or snakes). However, these channels do not stay open for long, and their role in long-term blood supply is minimal, if any. Other possibilities include damage to...

The Heart Lung Machine

From these early operations into the twentieth century, the development of heart surgery did not move very quickly until a single innovation, the heart-lung machine, ushered in the age of modern heart surgery. Before the invention of the heart-lung machine, surgeons confronted a very simple yet seemingly insurmountable problem. If the heart was stopped and opened so the surgeon could see it directly, the patient died. The heart-lung machine finally allowed physicians to stop the beating heart...

Heart Surgeon and Public Servant in the USSR

Heart surgery was a worldwide effort, with doctors in North and South America, Europe, the U.S.S.R., and elsewhere all pushing towards open heart surgery and techniques to correct many forms of heart disease. In the former Soviet Union, Dr. Nikolay Amosov became one of the leading surgeons of his day. In a recent Interview, Amosov remembered his introduction to medicine and his early days as a surgeon. I had been interested in medicine since my childhood, Amosov said. However, I happened to...

The First Heart Transplant

(always be remembered as the heart surgeon who performed the first successful heart transplant using a human donor heart. He attended medical school at the University of Cape Town, South Africa, where he received training in general surgery. Then, in 1956, he received a two-year scholarship to study surgery at the University of Minnesota in Minneapolis. I actually went to Minneapolis to study general surgery, Barnard recalled. I was working in a laboratory one day in general surgery when I...

The Dawn of Open Heart Surgery

Assumed the heart was too Important to Interfere with and too fragile to be operated on. In those days, cardiac problems often meant death. During the last fifty years, however, our understanding of the complicated cardiac system has increased greatly, and doctors now routinely perform surgeries that were once beyond the furthest reaches of medical imagination. The development of major surgery was retarded for centuries by a lack of knowledge and technology. Significantly, general anesthetics...

RenKe Li MD PhD Richard D Weisel MD and Donald AG Mickle MD

Department of Surgery and Laboratory Medicine and Pathology University of Toronto Toronto, Ontario, Canada AN ESTIMATED 465,000 PA- tients In the United States are diagnosed with congestive heart failure each year. For those patients with mild heart failure, medicine can often relieve their symptoms and improve their quality of life. However, for patients with severe heart failure, medicine may be insufficient, and heart transplantation may offer the potential for a better, longer life....

Diagnosing a Problem

ONCE A PHYSICIAN KNOWS THE (symptoms, a series of tests will help determine a diagnosis. Diagnosis literally means a determination of the cause of a problem, and diagnostic tests are done to find out what's causing the symptoms. In many ways, doctors are like detectives in that they are presented with a case and have to search out culprits and causes. Diagnosing illness is an art form unto itself, and doctors use some very sophisticated techniques. Among the most common tests is the...

Denton Cooley Inventor and Pioneer Surgeon

DENTON COOLEY, ONE OF heart surgery's most noteworthy pioneers, originally planned on becoming a dentist and taking over his father's practice. Although he was interested in medicine, he was worried that the academic track to a medical degree was too difficult. This fear was put to rest when he achieved the highest grades in his college fraternity. Soon after, Cooley transferred into medicine and eventually graduated from Johns Hopkins Medical School. During World War II, he also interned...

Heart Valve Replacement

If the heart valve cannot be repaired, physicians will most likely recommend heart valve replacement with either a mechanical heart valve or a tissue (biological) heart valve. When it comes to mechanical heart valves, some surgeons still use the original cage-ball valves. These valves have a good, long-term track record. Some patients have had the cage-ball valves for more than thirty years. The newer mechanical heart valves are made from carbon. They tend to be low profile so they take up less...

Heart Surgery Tables

Within a few years in the mid- to late 1950s, surgeons corrected thirteen types of congenital heart defects. Congenital heart surgery later evolved into its own subspecialty. A treatment that improves a condition but does not cure it. Complete atrioventricular canal 1954 Total anomalous pulmonary veins 1956 Congenital aneurysm, sinus of Valsalva 1956 Congenital aortic stenosis 1956 Double outlet right ventricle 1957 Corrected transposition of great arteries 1957 Transposition of great arteries...

Larry Stephenson MD

ON OCTOBER 8, 1999, AN article appeared on the front page of The New York Times with the headline, Fen-Phen Maker to Pay Billions in Settlement of Diet-Injury Cases. This article is hopefully the final chapter in the story of the popular diet drugs, which were removed from the market after they were linked to heart valve problems. According to The New York Times, anybody with a pill-related heart valve injury could receive as much as 1.5 million. Some six million people took the diet drugs,...

Renee S Hartz MD

Cardiothoracic Surgeon Professor of Surgery Tulane University Tulane Xavier Women's Center of Excellence New Orleans, Louisiana CORONARY ARTERY BYPASS grafting (CABG) is the most commonly performed surgical procedure in the United States. There are approximately 325,000 CABG procedures performed every year, and patients who receive this surgery benefit from more than thirty years of experience and published medical data on its relative safety. Just as CABG is the most commonly performed...

Vitamin E and the Heart

Vitamin E is an antioxidant found in vegetable oil, wheat germ, leafy vegetables, egg yolks, margarine, and legumes (beans). A number of recent studies have attempted to determine whether taking vitamin E supplements lowers the risk of atherosclerotic heart disease and heart attacks by inhibiting low-density lipoprotein (LDL, the bad type of cholesterol). In the early 1990s, three studies found no correlation between the naturally occurring level of vitamin E in the blood and heart attacks or...

Adrian Kantrowitz Intra Aortic Balloon Pump

ADRIAN KANTROWITZS MANY contributions to heart surgery early pacemakers and heart transplantation, for instance include the most practical heart assist device in use today the intra-aortic balloon pump. This novel device likely saves more than one hundred thousand lives every year worldwide. Kantrowitz developed the device with his brother Arthur, a Ph.D. physicist and former rocket scientist. Shortly after returning from service in World War II, Kantrowitz worked in the laboratory at Case...

Myocardial infarction See heart attack or

Myocarditis An inflammation of the heart muscle. myxoid degeneration Degeneration of the middle layer of tissue in blood vessels and heart valves. neonate A newborn child within the first few weeks of life. nitroglycerin A drug used to dilate coronary arteries so more oxygenated blood can reach the heart muscle. This drug is generally used by patients with atherosclerotic coronary artery disease. occlusion Narrowing or blockage of a blood vessel. open heart surgery Heart operations in which the...