2015-01 From the President: the Impact of Medical Science

The Impact of Medical Science

In 1960, January 1, I received a call from my brother-inlaw in Colorado — my father had just passed away with heart failure. He had an attack several days earlier and the small town hospital in eastern Colorado had little to offer him—comfort and care, but not much healing.

On Tuesday, October 21, 2014, I experienced tightness in my chest. Because I already had a pacemaker and stents, I carried a small bottle of nitro pills. I put one under my tongue and headed to the emergency room at Fairview-Southdale Hospital. In quick order I was given an EKG and blood tests, admitted for observation, then moved to the heart wing, associated with the University of Minnesota heart specialists at Fairview. The next day an angiogram showed the need for triple-bypass surgery. Three days after I entered the emergency room, I was wheeled into the operating room; the bypass was completed. Four weeks later, I was home, entering cardiac rehabilitation and planning UMRA activities for January.

What a difference 54 years has made! How many more years would my father have had if pacemakers, angiograms, stents, and bypass surgery had been available in eastern Colorado in 1960? At that time some of these life-saving procedures were just being tried in a few places in the world, most notably in Minnesota. Take open heart surgery, for example.

In 2009 the American Heart Association publication, Circulation, carried an article by Dr. William S. Stoney, emeritus professor of Cardiac and Thoracic Surgery at Vanderbilt University School of Medicine. Tracing the development of open heart surgery in his article, "Historical Perspectives in Cardiology: Evolution of Cardiopulmonary Bypass," Stoney detailed the contributions of Minnesotans to bypass surgery.

"There was a great deal of excitement about cardiac surgery developing at the University of Minnesota and the Mayo Clinic. It all started in 1945. The chairman of the University's Department of Surgery, Dr. Owen Wangensteen, asked his younger faculty member, Clarence Dennis, to see if he could develop a heart-lung machine."

Dennis did develop an early machine. Another of Wangensteen's team, Dr. John Lewis, using patient hypothermia, conducted what Stoney called, "the first successful open heart operation ever performed." A third Wangensteen protégé, Dr. C. Walton Lillehei, is frequently referred to as "the father of open heart surgery."

As Stoney puts it, "Once the heart-lung machine was developed and perfected, largely due to the work of Dr. John Gibbon of the Mayo Clinic and Richard DeVall of Lillehei's team, the word of this new development spread rapidly through the surgical world. Surgeons could watch open heart operations in the morning, and in the afternoon they could visit the experimental laboratory where Devall and Vincent Gott would show them how to set up the bubble oxygenator and purchase one for less than $1,000. It was this inexpensive device that made it possible for many medical centers to start a cardiac surgery program."

Lillehei was responsible for a long list of contributions in the field and trained many young surgeons who became major contributors to heart research and surgery.

About this time, Dr. John Kirklin of the Mayo Clinic also began conducting open heart surgeries. Dr. Stoney writes, "For a brief period of time (1955-56) there were only two hospitals in the world where open heart surgery was being done on a daily basis: Lillehei at the University of Minnesota and, 60 miles away, John Kirklin at the Mayo Clinic. Surgeons came in droves from all over the world to see these two men at work."

Clearly, Minnesota has made important contributions to the development of open heart surgery. From early experiments with heart-lung machines to the training of countless surgeons, this successful high-risk treatment of the ailing heart has lengthened the lives of thousands. Several UMRA members are among them.

As one of those survivors, and in behalf of many others, I thank doctors Wangensteen, Lillehei, Kirklin, and dozens of other Minnesotans working with them, for their contributions to bypass surgery.

It is easy to take successful operations for granted. Things that were considered terminal not so long ago are now held at bay or even cured. Our longevity is increasing, giving us the opportunity to live well in our later years.

— Hal Miller, UMRA President miller@umn.edu