The dawn of heart surgery.
Clarence Walton Lillehei was known as the “father of open heart surgery”. Indeed, hardly any other cardiac surgeon has introduced a greater number of innovative techniques and concepts.
During his career, Dr Lillehei focused his efforts on cardiac surgery, particularly the development of open heart operations. The difficulty of operating on a beating heart and the hypoperfusion of the vital organs were serious and frequent complications of heart surgery. In 1953, Dr John Gibbon of Philadelphia successfully closed an atrial septal defect using a complex screen oxygenator and roller pumps. However, the mortality of open heart surgery remained high, mainly because of oxygenator-related problems, and many surgeons despaired of ever being able to correct complex intracardiac defects.
This situation was changed in March 1954 when Dr Lillehei and his associates—Morley Cohen, Herb Warden, and Richard Varco— used controlled cross-circulation to correct a ventricular septal defect in an 11-year-old boy. The boy’s anesthetized father served as the oxygenator. Blood flow was routed from the patient’s caval system to the father’s femoral vein and lungs, where it was oxygenated and then returned to the patient’s carotid artery. The cardiac defect was repaired with a total pump time of 19 minutes. Over the ensuing 15 months, Lillehei operated on 45 patients with otherwise irreparable complex interventricular defects; most of these patients were less than 2 years old. Although cross-circulation was a major advance, it was not adopted for widespread use because it posed a serious risk to the “donor”. Nevertheless, this method paved the way for the open heart surgery era.
That same year, Dr Richard A. DeWall and Dr Lillehei introduced the first clinically successful bubble oxygenator, which remained the standard for extracorporeal circulation until the late 1970s. Dr Lillehei also helped pioneer hemodilution and moderate hypothermia techniques for open heart surgery.