Heart Surgery
Heart Surgery or cardiac surgery is surgery on the heart and/or great
vessels. Frequently, it is done to treat complications of ischemic
heart disease (e.g. coronary artery bypass grafting), correct congenital
heart disease, or treat valve problems created by various causes including
endocarditis. It also includes heart transplantation, which is covered
in the article heart
transplant.
History of Heart Surgery
The earliest operations that can be considered heart surgery were
limited to the pericardium, and were pioneered by, among others, Francisco
Romero,[1] Dominique Jean Larrey, Henry Dalton, and Daniel Hale Williams.
The first successful surgery on the heart itself, performed without
any complications, was by Dr. Ludwig Rehn of Frankfurt, Germany, who
repaired a stab wound to the right ventricle on September 7, 1896.
It was soon discovered that the repair of intracardiac pathologies
required a bloodless and motionless environment, which means that the
heart should be stopped and by-passed by use of an extracorporeal circulation
technique, hence the term of cardiopulmonary bypass. The first successful
intracardiac correction of a congenital heart defect using hypothermia
was performed by Dr. C. Walton Lillehei and Dr. F. John Lewis at the
University of Minnesota on September 2, 1952. Dr. John Heysham Gibbon
at Jefferson Medical School in Philadelphia reported in 1953 the first
successful use of extracorporeal circulation by means of a pump-oxygenator,
but he abandoned the method, disappointed by subsequent failures. In
1954 Dr. Lillehei realized a successful series of operations with the
controlled cross-circulation technique in which the patient's mother
or father was used as a 'heart-lung machine'. Dr. John W. Kirklin at
the Mayo Clinic in Rochester, Minnesota started using a Gibbon type
pump-oxygenator in a series of successful operations, and was soon
followed by surgeons in various parts of the world.
Recently, however, doctors have begun to perform "beating heart
surgery," a phrase used to describe cardiac surgery done without
the aforementioned bypass pump mechanism. In these operations, the
heart is beating during surgery. Some researchers believe this approach
results in fewer post-operative complications (such as pumphead syndrome)
and better overall results. The Heart Surgery USA website provides
a summary of recent work in this area.
Heart Surgery Risks
The development of heart surgery and cardiopulmonary bypass techniques
has reduced the mortality rates of these surgeries to relatively low
levels. For instance, repairs of congenital heart defects are currently
estimated to have 4-6% mortality rates.
The biggest risk associated with heart surgery is brain damage. Despite
the advances in CPB techniques, it is estimated that as many as 60%
of all patients demonstrate varying levels of brain damage following
the surgery; in 25% of patients this damage becomes permanent. It can
range from fine motor skill dysfunctions to mental retardation.
Heart Surgery Resources:
Information obtained from Wikipedia, the free encyclopedia
