Years Of Pioneering Surgical Advances
NewYork-Presbyterian/Columbia physicians also marked with milestone with a white paper published in Seminars in Thoracic and Cardiovascular Surgery. Dr. Michael Argenziano, chief of adult cardiac surgery and director of the Minimally Invasive Cardiac Surgery and Surgical Arrhythmia programs at NewYork-Presbyterian/Columbia University Medical Center, along with his colleagues Drs. Craig Smith, Henry Spotnitz, Kenneth Steinglass and Emile Bacha, recount the history of the institutions historic initiatives in cardiothoracic surgery, underscoring that their commitment to clinical care, education and innovation has never been greater.
As the nations first academic medical center, NewYork-Presbyterian/Columbia University Medical Center is no stranger to achieving firsts, especially in cardiothoracic surgery. From the first open heart operation on a child with a congenital heart defect in 1956, to the worlds first pediatric heart transplant in 1984, to performing the first totally endoscopic, robotic open-heart surgery in 2001, the institutions continue to pioneer advancements in clinical care, education and innovation today.
All of the progress weve made and continue to make has been driven by the physicians, researchers, students and staff, nurses and technicians that have worked here throughout the generations. Their talent, drive, commitment to care and to bettering patients lives allows our cardiothoracic surgery program continues to thrive, said Dr. Argenziano.
Sidra Medicine Performs First Open
Sidra Medicine performed the first open-heart surgery in its newly opened Heart Center in July. The Sidra Medicine Heart Center is one of the institutions flagship programs and is positioned to become a leading center in the region for patients suffering from congenital heart disease. Patients in Qatar and the region now have access to state-of-the-art equipment and an international team of experts able to perform the most complex cardiological procedures in Qatar, eliminating the need to travel abroad for care.
The first open-heart surgery was performed on a three-year old patient who was diagnosed with atrial septal defect, which manifests as a hole in the heart. Dr. Olivier Ghez, Sidra Medicines Division Chief of Cardiac Surgery, led a multidisciplinary team of 10 medical professionals during the successful 2-hour surgery to correct the defect. The team included Dr. Reema Kamal who is a Qatari division chief of cardiology.
My family and I are so thankful for the care we received at Sidra Medicine. The doctors and allied staff were so supportive and helpful throughout the entire process and our son was discharged in less than one week. I am relieved that we could access the right care so close to home and so efficiently, said the boys mother.
The Heart Center is equipped with state-of-the-art equipment and facilities designed to enable clinical teams to achieve the highest standard of care and the best possible experience for patients and their caregivers.
Celebrating Black History: The First Successful Open Heart Surgery
To celebrate, each week throughout Black History Month, Trusted Medical will spotlight an African American medical pioneer whose groundbreaking contributions changed the course of medicine and paved the way for future generations. We begin with a man who performed the first successful open-heart surgery, Dr. Daniel Hale Williams. Keep reading to learn more about Dr. Daniel Hale Williams and his groundbreaking role in the field of medicine.
Born in 1856 in Pennsylvania, Dr. Daniel Hale Williams began his career as a shoemakers apprentice. He then took up barbering, following in his fathers footsteps for a short time. Ultimately, Williams decided he wanted to pursue his education and started an apprenticeship under Dr. Henry Palmer, a highly accomplished surgeon. He went on to complete further training at Chicago Medical College.
Graduating with his M.D. in 1883, Dr. Williams became a surgeon in the Chicago area at a time when there were only three other Black physicians in Chicago. As a practicing surgeon during the segregation era, he was prohibited from being admitted and working at hospitals. In response, Dr. Williams founded the Provident Hospital and Training School, the first Black-owned hospital in the United States and the first medical facility with an interracial staff.
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C Walton & Richard C Lillehei Surgical Society
In 1986, the Lillehei Surgical Society was founded to honor and perpetuate the contributions of the three Lillehei brothers, C. Walton, Richard, and James, to the field of cardiovascular care. In 1987, The Lillehei Surgical Society created and funded the Land Grant Chair at the University of Minnesota.
Currently, the membership includes more than 200 first, second, and third generation Lillehei trained cardiovascular and thoracic surgeons, as well as principals in the biomedical product and service industry. The Society offers an annual membership meeting and social function. Also, on a bi-annual basis, a Scientific Symposium is held to interact first hand with leaders in the international cardiovascular and thoracic community. These events are held to coincide with the date and location of the annual Society of Thoracic Surgeons meeting.
For information regarding membership requirements, please contact:
Meet The Black Surgeon Who Performed Worlds First Successful Open Heart Surgery In 1893
Mildred Europa Taylor | Head of Content
In 1893, exactly 125 years ago today, Dr Daniel Hale Williams, an African-American cardiologist became the first surgeon to perform a successful open-heart procedure in the United States.
Known as the father of black surgery, Williams surgery became a significant feat in medical history and an important step in the fight for equality at the time, since he was one of the few black cardiologists in the US at the time.
Born on January 18, 1858, in the small town of Hollidaysburg in central Pennsylvania, Williams and his family had to move to Marylands capital city, Annapolis.
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Daniel Hale Williams Performed The First Successful Open Heart Surgery During An Emergency Procedure
When James Cornish stumbled into the recently established Provident Hospital one summer night in 1893, he probably wasnt thinking about making history or being part of a seminal moment in both American medical advancement and racial politics. Instead, he was more likely concerned with the significant amount of blood he was losing from the several deep stab wounds in his chest, which clearly required emergency treatment.
Fortunately, Cornish, a young Black man, staggered into the race-inclusive Provident Hospital, the first Black-owned and operated hospital in the United States, during an evening in which its founder, a brilliant surgeon named Daniel Hale Williams, was on the premises. As Cornishs condition worsened, Williams made the bold choice to operate directly on his heart, attempting what was at the time medically unprecedented.
Daniel Hale Williams And The First Successful Heart Surgery
A people who dont make provision for their own sick and suffering are not worthy of civilization.Daniel Hale Williams
The son of a barber, Daniel Hale Williams founded the first black-owned hospital in America, and performed the world’s first successful heart surgery, in 1893. Williams was born in 1858 in Hollidaysburg, Pennsylvania, the fifth of seven children. After his father died, his mother, Sara Price Williams, moved the family several times. Young Daniel started as a shoemaker, but quickly knew he wanted more education. He completed secondary school in Wisconsin. At age 20, Williams became an apprentice to a former surgeon general for Wisconsin. Williams studied medicine at Chicago Medical College.
After his internship, he went into private practice in an integrated neighborhood on Chicago’s south side. He soon began teaching anatomy at Chicago Medical College and served as surgeon to the City Railway Company. In 1889, the governor of Illinois appointed him to the state’s board of health.
Determined that Chicago should have a hospital where both black and white doctors could study and where black nurses could receive training, Williams rallied for a hospital open to all races. After months of hard work, he opened Provident Hospital and Training School for Nurses on May 4, 1891, the country’s first interracial hospital and nursing school.
Dr. Williams died in 1931. The Daniel Hale Williams Medical Reading Club in Washington, D.C., commemorates his achievements.
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Anaesthesia And Monitoring On Cpb
Perfusion pressure is used as a surrogate marker of organ perfusion and should be maintained between 50 and 70 mmHg. Hypertensive patients and those at risk for stroke require higher flows and perfusion pressures to maintain organ perfusion. Cerebral oximetry, evoked potentials and transcranial Doppler can be used to assess the adequacy of cerebral blood flow. Mixed venous oxygen saturation monitoring can provide an estimate of the balance between global oxygen delivery and demand. Mixed venous oximetry of 70% or greater is maintained, but even this does not guarantee adequate perfusion of all tissue beds.
Blood level in the reservoir should be monitored to prevent air embolism. Central venous pressure should be low. High CVP indicates a poor venous return. Monitoring of aortic line pressure, blood temperature and integrity of gas supply to the oxygenator is essential. Glucose is maintained between 120 and 180 mg/dL. Anaesthesia can be maintained by inhalational route or total intravenous anaesthesia can be given. Volatile anaesthetics provide cardioprotective effects through preconditioning. Nitrous oxide is avoided during CPB to prevent an increase in the size of air emboli. Anaesthetic requirements are reduced with hypothermia, however drug pharmacokinetics are also altered due to haemodilution and altered metabolism leading to variable effect.
Our Surgical Heritagefirst Successful Open
A pioneering surgeon at the University of Minnesota, Dr C. Walton Lillehei, is still considered the father of open-heart surgery. Dr Lillehei and his surgical team performed the first open-heart operations utilizing cross-circulation, including the first successful closure on a 3-year-old boy. Before his death at age 67, this patient arranged to donate his body to the University of Minnesotas Anatomy Bequest program. We describe this patients medical history, and present unique images of internal/external cardiac anatomies and implanted devices obtained via direct visualizations, , and post-mortem. Additionally, we present computational models and 3-dimensional printed models.
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Fast Facts: John Heysham Gibbon
- Known For: Inventor of the heart-lung machine
- Born: Sept. 29, 1903 in Philadelphia, Pennsylvania
- Parents: John Heysham Gibbon Sr., Marjorie Young
- Died: Feb. 5, 1973 in Philadelphia, Pennsylvania
- Education: Princeton University, Jefferson Medical College
- Awards and Honors: Distinguished Service Award from International College of Surgery, fellowship from Royal College of Surgeons, Gairdner Foundation International Award from University of Toronto
- Spouse: Mary Hopkinson
- Children: Mary, John, Alice, and Marjorie
The First Heart Operation
The patient was a young black man named James Cornish. He had been rushed to Provident Hospital on the South Side with a knife wound in his chest from a barroom brawl. Dr. Daniel Hale Williamsa founder of Provident, which had opened two years previously as the citys first interracial hospitalknew Cornish was bleeding to death. On this hot summer night, Williams performed a desperate operation that helped set the stage for modern surgery.
Medical textbooks of the time said that operating on a human heart was too dangerous, and there was no precedent for opening the chest. But Dr. Dan, despite having no X-rays, antibiotics, adequate anesthesia and other tools of modern surgery, stepped into that medical no-mans-land. With a scalpel, he cut a small hole in Cornishs chest, carefully picking his way past nerves, muscle, blood vessels and ribs until he reached the rapidly beating heart. Exploring the wound, Williams found a severed artery. He closed it with sutures, but then discerned an inch-long gash in the pericardium, the tough sac that surrounds the heart. The heart itself had only been nicked and did not need sutures. But the damaged sac had to be closed. With Cornishs heart beating 130 times a minute beneath his nimble fingers, Williams closed the wound with catgut.
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Who Is The Best Medical Doctor In The World
10 doctors who changed the world
- Helen Brooke Taussig, MD: A pioneer in pediatric cardiology.
- Charles Richard Drew, MD: Father of the blood bank.
- Michael Ellis DeBakey, MD: Pioneer of cardiovascular surgery.
- Virginia Apgar, MD: Inventor of the Apgar Score.
- Georges Mathé, MD: Discovered treatment for leukemia.
Williams Rose From Humble Beginnings To Become A Trailblazer
Born in Pennsylvania in 1856, Williams began working by the time he was 10 years old, following his fathers death from tuberculosis. Williams apprenticed for a shoemaker in Maryland and then ran off to join the rest of his family in the Midwest, where he worked in the family barbershop business. When he was 22, Williams was inspired by a local doctor to pursue a career in medicine.
Systemic segregation meant that medical education opportunities were very limited for Black Americans at the time, but after studying for several years with a famed surgeon for two years in Wisconsin, Williams matriculated at Chicago Medical College . He took out loans for his first two years and then was helped along by his brother, a local lawyer. It would prove to be a very wise investment on his brothers part.
Williams established his own private practice after graduating in 1883, but he had to perform care including surgeries on patients inside their homes, as hospitals at that point largely did not allow Black doctors to practice in their facilities.
Daniel Hale Williams
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The Early Days Of Heart Surgery
Before World War II, even on a world scale, cardiac and great vessel surgery was still in its infancy, and was limited to surgeries for pericarditis and cardiac trauma. In Japan, Seo of Chiba University performed pericardiectomies in three cases of constrictive pericarditis in 1928.
The first surgical operation for cardiac trauma in Japan was performed by Tohru Sakakibara of Okayama City Sakakibara Hospital. In 1936, he performed pericardiotomy on a construction worker, relieving that patients cardiac tamponade, which had resulted from a stabbing in a fight, and he staunched the hemorrhage from the heart by pressure using gauze. In the following year, Ozawa et al. from Osaka University sutured a wound inflicted by an iron fragment in the right ventricle of a patient, which resulted in an impassioned discussion at a National Conference of the Japan Surgical Society between Sakakibara and Ozawa regarding the techniques used for hemostasis
Incidentally, in other countries, pericardiectomy has been performed since Weils first operation in 1885, and suturing of the heart, since Rehns 1896 operation, indicating that cardiac surgery in Japan had a much later start than that in the West.
Open Heart Surgery Patient Risk
The risk of open heart surgery to any patient is very dependent on the patient themselves and how sick they are. Of course a healthy 45 year old is going to have a lower risk than an 85 year old. Several risk factors have been found to be important when determining the risk for any given patient.
Age Older patients are in general at higher risk than younger patients.
Sex In general female patients have higher risk than make patients.
Obesity Obese patients are at higher risk.
Heart Function Pumping function of the heart is important those with impaired heart pumping function are at higher risk.
Kidney Function Patients with impaired kidney function have higher risk the worse the kidney function the higher the risk.
Heart Attack Those that have had a heart attack are at higher risk, particularly if the heart attack is around the time of surgery or if there are active symptoms of chest pain at the time of surgery.
Lung Disease Those with known lung disease, such as COPD, are at higher risk the worse the lung disease the higher the risk.
Emergency Surgery Surgery that needs to be performed emergently due to active symptoms, or instability carries a much higher risk than elective planned surgery.
Presence of Multiple Problems The more issues that need fixing, the higher the risk for example someone needing a simple bypass operation is lower risk than someone needing a bypass and 2 valves fixed at the same time.
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Surgery Of The Great Vessels
The worlds first resection of an abdominal aortic aneurysm was performed in 1951 by Dubost, who replaced the aorta with a cadaver allograft. Japans first abdominal aortic aneurysmectomy was carried out on July 25, 1952. Kimoto of the University of Tokyo in this case used an alcohol-preserved allograft as a replacement, and on February 18, 1953, in another case, transplanted a section of similarly preserved sheeps aorta. The former patient died seven years later of an aortoduodenal fistula, while the latter survived for 11 years before succumbing to a subarachnoid hemorrhage. Although, in the autopsies, the sheeps aorta showed some atherosclerosis, it had become indistinguishable from the patients own aorta. In the first case in which an artificial graft for the abdominal aorta was used, Ohhara, at Tohoku University, used a nylon prosthesis, but in 1959, under the direction of Tatsuo Wada, the manufacture of crimped Dacron prostheses was initiated, and abdominal aortic aneurysm surgery began to spread.
Descending aortic aneurysmectomy was first done in July 1956 by Kimoto using a nylon vascular prosthesis. Kiyoshi Miyamoto of the University of Tokyo reported spinal fluid drainage during occlusion of the descending aorta to make possible protection of the spinal cord, a procedure that was an innovative step in Japanese vascular surgery and that is still in clinical use around the world.
Celebrating Achievements Paying Tribute To The Past
Cardiac surgery is a complex intervention and success has depended on effective teamwork, both within and between organisations. Patient outcomes have dramatically improved. The days when it was touch and go whether someone would come out of the operating room are long past. This is a very different environment to that of 40 years ago, especially in my field of congenital heart surgery.
The patients who required heart surgery in the early years of the NHS were very, very brave. Of course, as results have improved, so have peoples expectations. Surgeons should be ruthlessly honest about the way that patients are advised about their treatment options. The expectation of many people today is that they can have an operation with a predictably perfect outcome that sadly isnt always the reality.
But when you think of the great names associated with Royal Brompton, for example Paul Wood, Russell Brock, Magdi Yacoub and Jane Somerville, patient outcomes have improved massively compared to those which could have been anticipated in the 1950s.
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