Experimental closure of interventricular septal defects and further physiologic studies on controlled cross circulation.

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Ammerican College of Surgeons, 1954. - Philadelphia. W.B. Saunders Company, 1954, 8°, pp.22-28, orig. self wrappers. Offprint! From the Departments of Surgery and Anesthesiology, University of Minnesota Medical School, Minneapolis. This study was supported by research funds from: (1) Graduate School, University of Minnesota; (2) Minnesota Heart Association; (3) Life Insurance Medical Research Fund; (4) United States Public Health Service Research Grant (H-830). "Controlled cross circulation has been employed in this clinic over the past nine months for the direct vision intracardiac correction of congenital heart defects in twenty-one patients.*) Concomitantly, work has continued in the laboratory to further evaluate this method of performing prolonged open intracardiac surgery. Many of the problems that were evident in the early experimental work, such as fibrillation, have not been encountered in the clinical experience to date, while the latter has emphasized certain features which had not been explored. Among these was the increase in the donor's respiratory minute volume necessary to maintain his alveolar pCO2 within normal limits ." Warden, et al. *) Since the presentation of this paper an additional 11 patients have been operated upon, making the present total 32. Of these, 22 were suture closure of ventricular septal defects, with 7 deaths; 6 were for the curative treatment of the tetralogy of Fallot defect, with 3 deaths; 2 were for correction of atrioventricularis communis defects, with 1 death; and 1 patient with a complicated defect (pulmonic stenosis, interatrial septal defect, and anomalous pulmonary drainage) did not survive corrective surgery. There has been no donor mortality in these 32 operations. "Lillehei had to undertake controlled cross-circulation in humans in the face of strong opposition, especially from Professor Cecil Watson (1901-83), then Chairman of the Department of Medicine at the University of Minnesota. The general concern was that two individuals, one of them being otherwise healthy, were sharing an unquantifiable risk. The procedure was first used on 26 March 1954 when Gregory Glidden, 13 months old and a victim of repeated bouts of pneumonia and heart failure, underwent ventricular septal defect repair after being connected up to his father, Lyman Glidden. Perfusion was carried on for 13 minutes and the operation went smoothly, the defect being closed by direct suture. After initial good progress, the boy unfortunately developed pneumonia, dying 11 days later. The surgical team consisted of Lillehei, Morley Cohen, Herbert Warden (1920-2002) and Richard Varco. Between 1954 and 1955 Lillehei et al. used this procedure 45 times at the University of Minnesota, with infants or children as patients. A parent or a close relative with the same blood type was connected to the child's circulation. There were no donor fatalities and no long-lasting donor sequelae. Controlled cross-circulation was associated with the first total corrections of ventricular septal defect, Tetralogy of Fallot and atrioventricular canal defects." Ashis Banerjee: C. Walton Lillehei (1918-99): the versatile pioneer of open-heart surgery. Journal of Medical Biography, 16/3 (2008): pp. 150-154 Clarence Walton Lillehei (1918-1999), was an American surgeon who pioneered open-heart surgery, as well as numerous techniques, equipment and prostheses for cardiothoracic surgery.…

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Bibliografische Details

Titel
Experimental closure of interventricular septal defects and further physiologic studies on controlled cross circulation.
Autor
Warden, Herbert E.; Cohen, Morley; De Wall, Richard A.; Schultz, Earl A.; Buckley, Joseph J.; Read, Raymond C. & Lillehei, C. Walton
Erscheinungsjahr
1954
Einband
Softcover
Verkäuferkataloge
Chirurgie

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