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Beyond the microscope: How did the major innovations in cardiac surgery of the 20th century transform medicine?
Heart surgery, or cardiovascular surgery, is surgery on the heart or major blood vessels performed by a cardiac surgeon. This surgery is often performed to treat complications of ischemic heart disease, such as coronary artery bypass grafting; to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease and atherosclerosis. Heart transplantation also falls under this category of surgery.
A brief history
19th century
Heart surgery in the 19th century began with pericardial manipulation, and famous doctors such as Francisco Romero and Daniel Hale Williams performed such operations in Spain and the United States. Axel Cappelen performed the first heart surgery in 1895 in Rikshospitalet, Norway, when he repaired the coronary artery of a patient who had been stabbed by a bear. Although the patient who operated on initially appeared to be stable, he eventually succumbed to infection.
20th Century
As the 20th century unfolded, the scope of cardiac surgery continued to expand, improving treatments for a variety of conditions. For example, Henry Souttar's successful operation on a young woman with mitral stenosis in 1925 is considered the beginning of heart valve surgery. In addition, the first successful pediatric cardiac surgery performed by Alfred Blalock and his team at Johns Hopkins Hospital in 1944 is considered the beginning of modern cardiac surgery.
"Changes in cardiac surgery are not only due to advances in technology, but also involve the success of interdisciplinary collaboration."
After World War II, further major breakthroughs were made in cardiac surgery technology. In 1947 Thomas Sellors performed an operation on a pediatric patient with congenital heart disease, demonstrating the potential of surgery in such conditions. In 1953, surgery using an oxygenator experienced setbacks but laid the foundation for future groundbreaking advances.
Types of cardiac surgery
Open heart surgery
Open-heart surgery is an operation performed by a surgeon on the chest, which usually requires a larger incision so that the surgery can be performed directly on the heart. During this type of surgery, the heart is temporarily stopped and the patient receives blood and oxygen through an extracorporeal circulation machine.
Heart transplant
In the field of heart transplantation, Christiaan Barnard from South Africa successfully performed the world's first adult heart transplant in 1967, marking a major innovation in human medical care.
Coronary artery bypass grafting
Coronary artery bypass grafting (CABG) is a common surgery for ischemic heart disease to provide a new blood supply to the heart and body and reduce the risk of heart attack.
Minimally invasive surgery
As an alternative to open-heart surgery, minimally invasive surgery is performed using small incisions and using special cameras and tools. Robot-assisted surgery is an evolving field, and research shows it is a safe alternative technology.
Postoperative procedures and risks
After cardiac surgery, patients need to follow post-operative care to avoid complications. Common postoperative points include incision care, monitoring heart rate, blood pressure, and blood oxygen levels.
"Although the risks of cardiac surgery continue to decrease, the impact on the nervous system remains an important postoperative consideration."
As cardiac surgery advances, the risk of nerve damage remains, and the possibility of post-operative stroke or other neurocognitive symptoms that, while initially thought to be permanent, later turn out to be transient.
Conclusion
The innovations in cardiac surgery in the 20th century not only demonstrated the miracle of medical technology, but also brought good news to countless patients. As technology continues to advance, how will future heart surgery further change our understanding of and treatment of disease?
