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 that corrected a defect in the aorta called coarctation of the aorta.

culation of one dog was used to support that of another dog while the second dog's heart was temporarily stopped and opened. After a simulated heart repair in the second dog, the circulations of the two animals were disconnected and they were allowed to recover.

But this technique was fraught with ethical issues. Lillehei himself remarked that "clinical cross circulation for intracardiac surgery was an immense departure from the established surgical practice This thought of taking a normal human to the operating room to serve as a donor circulation (with potential risk, however small) even temporarily was considered by critics at that time to be unacceptable, even immoral."

Others were "quick to point out that this proposed operation was the first in all of surgical history to have the potential for a 200 percent mortality."

Moreover, there were practical problems with the technique, including blood type. Cross circulation would work only for people with the same blood type. There was also a problem with blood volume — how much work would the nonsurgical patient's heart have to do?

In spite of these obstacles, Lillehei wrote, "The continued lack of any success in the other centers around the world that were working actively on heart-lung bypass made the decision to go ahead (with cross circulation) inevitable. I felt the technique was ready to use in a human; however, even in such a progressive and primary medical school as the University of Minnesota, there was opposition to the idea. Dr. Owen Wangensteen, chairman of the Department of Surgery, was a tremendous help. He was well aware of these experiments and wholeheartedly supported them. Where there seemed a possibility that the first clinical operation might be canceled the night before because of opposition, I left a note for Dr. Wangensteen, 'Is our case still on in the morning?' His answer: 'Dear Walt: By all means, go ahead.'"

During cross circulation for repair of a congenital defect in a child, a major artery and vein in the parent's groin were

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