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Surgical palliation of hypoplastic left heart syndrome: is there a role for hypothermic circulatory arrest?

Published online by Cambridge University Press:  21 September 2005

Marshall L. Jacobs
Marshall L. Jacobs
Affiliation:
Department of Cardiothoracic Surgery, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, USA
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Extract

The technique of deep hypothermia with circulatory arrest has been important in the history of the evolution of cardiac surgery. Wilfred G. Bigelow, working in Toronto in the late 1940s, performed pioneering research on hypothermia, and developed a workable technique of hypothermia in human cardiac surgery.1 Based upon Bigelow's experimental premises, F. John Lewis, at the University of Minnesota, also conducted a number of experiments utilizing hypothermia. On September 2, 1942, Lewis operated on a 5-year-old girl with an atrial septal defect under general hypothermia with inflow occlusion. He was assisted by Richard Varco, Mansur Taufic, and C. Walton Lillehei. Rubberized refrigerated blankets were used to cool the patient to 28°C. The septal defect was closed during five and a half minutes of inflow occlusion. This was the world's first successful open operation on the human heart performed under direct vision, and marked the beginning of the era of open heart surgery. Now, as amazing and as primitive as that methodology may seem, those of you who read Life magazine, or watch the Discovery Channel on television, are aware that, in parts of the Soviet Union, a large fraction of today's open heart surgery is performed not using the technique of cardiopulmonary bypass, but rather using the methodology of immersion hypothermia from the 1950s, with surprisingly good results.

Type
Norwood Procedure and Staged Palliation
Information
Cardiology in the Young , Volume 14 , Issue S1 , February 2004 , pp. 65 - 69
Copyright
© 2004 Cambridge University Press

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