Written by: Thisandi Male Pathiranage
Edited by: Jessica and Aleeza
Background Information
Open-heart surgery, also known as traditional heart surgery, involves surgeries performed on the muscles, valves, or arteries of the heart via an incision into the chest. Nowadays, there are methods where open-heart surgery procedures can be performed with small incisions as opposed to wide openings. Heart-lung machines are also used during open-heart surgery. The machines circulate and oxygenate the blood to be maintained outside of a patient’s body. Open-heart surgery is done to repair or replace heart valves and repair damaged or abnormal areas of the heart. Open-heart surgery is also utilized when implanting medical devices that maintain a proper heartbeat, as well as replacing a damaged heart with a donated one. In addition, an individual may need to undergo open-heart surgery if they have coronary heart disease. The disease is caused by a buildup of plaque in artery walls. Therefore, open-heart surgery is necessary in order to perform a coronary artery bypass graft (CABG).
Open-Heart Surgery Techniques
Before cardiopulmonary bypass devices such as the heart-lung machine were invented, valve disease and congenital defects were inoperable or treated by closed-heart procedures. This was due to the challenge of being able to safely operate inside the heart during surgery. A variety of techniques such as the Gross atrial well and even hypothermia were proposed to surmount this problem. However, these methods were not dependable and had severe drawbacks including irreparable lesions and defects.
History of Successful Open-Surgery Operations
The surgery that is widely regarded as the world’s first successful open-heart surgery was done by Daniel Hale Williams, in 1893. He was able to treat a patient named James Cornish, a young man with a stab wound that was initially deemed as lethal. In order to treat Cornish, Williams cut the rib cartilage and created a small trapdoor to operate on the heart. Just 51 days after his operation, Cornish was released from the hospital and managed to live 20 years after surgery. Williams became highly acclaimed and the surgery was dubbed a landmark operation.
The development of a heart-lung machine allowed surgeons to access a dry and motionless heart. The first successful open-heart procedure with a heart-lung machine was performed by John H. Gibbon Jr. in 1953. Gibbon utilized the procedure to close an atrial septal defect, a hole in the wall between the upper chambers of the heart. His open heart technique was tested on four patients with congenital heart disease, and unfortunately, only one individual survived.
Another pioneering open-heart operation was performed by C. Walton Lillehei, who is regarded as the “Father of Open Heart Surgery”, in 1954. He used a cross-circulation method where an individual served as an oxygenator, cross-circulating their arterial blood into the recipient. This ensured that the amount of venous blood being returned would be controlled. The surgeon had a maximum of one hour to perform an intracardiac repair while utilizing this method. This cross-circulation technique had the ability to successfully correct heart-related issues such as ventricular septal defects.
Conclusion
Over time, surgeons have been able to develop simplified techniques in order to extend their usage of open-heart surgery. Through a variety of methods including the utilization of a heart-lung machine and cross-circulation, surgeons have made significant advances in the field of cardiology. Cardiothoracic surgeons are now able to repair a multitude of intracardiac abnormalities.
Bibliography
Daniel Hale Williams and the First Successful Heart Surgery. (n.d.). Retrieved March 16, 2021, from https://columbiasurgery.org/news/daniel-hale-williams-and-first-successful-heart-surgery
Denton A. Cooley and O. H. Frazier, Cooley, D., Denton A. Cooley From the Texas Heart Institute at St. Luke’s Episcopal Hospital, Frazier, O., O. H. Frazier From the Texas Heart Institute at St. Luke’s Episcopal Hospital, & Correspondence and reprint requests to Dr. Denton A. Cooley. (2018, March 22). The Past 50 Years of Cardiovascular Surgery. RetrievedMarch16, 2021, from https://www.ahajournals.org/doi/10.1161/circ.102.suppl_4.IV-87
Open-Heart Surgery. (2018, January 30). Retrieved March 16, 2021, from https://www.healthline.com/health/open-heart-surgery
Open-heart surgery. (n.d.). Retrieved March 16, 2021, from https://www.britannica.com/science/open-heart-surgery
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