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The History of Pediatric Cardiology and Cardiovascular Surgery

The History of Pediatric Cardiology and Cardiovascular Surgery. Pediatric cardiology and pediatric cardiac surgery have developed interdependently. CHD: Primordial heart?. FISH 1A+1V AMPHIBIA 2A+1V Snakes rudiment. VS REPTILES 2A+2V Turtles spongy VS

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The History of Pediatric Cardiology and Cardiovascular Surgery

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  1. The History of Pediatric Cardiology and Cardiovascular Surgery Pediatric cardiology and pediatric cardiac surgery have developed interdependently

  2. CHD: Primordial heart? • FISH 1A+1V • AMPHIBIA 2A+1V Snakes rudiment. VS • REPTILES 2A+2V Turtles spongy VS • BIRDS 2A+2V Alligators VSD • MAMMALS 2A+2V

  3. Scientific medicine begins

  4. Marcello Malpighi—1661

  5. Anton van Leeuwenhoek—1674

  6. Antoine Lavoisier—1777

  7. Early scientific foundations • 1785 William Withering introduces Foxglove • 1790 Luigi Galvani--electrical stimulation of frog muscle • 1808 Humphrey Davy identifies Na, K, Mg, Ca, Sr, & Ba • 1830s Claude Bernard--wide-ranging experiments • 1830s Michael Faraday--electricity: anode, cathode, electrolyte, anion and cation. • 1880s Joseph Lister--antiseptic surgery (phenol) • 1883 Ringer shows that K inhibits, Ca stimulates heart • 1887 Augustus Waller--Hg cardiogram • 1903 Willem Einthoven invents the string galvanometer EKG • 1895 Wilhelm Conrad Roentgen--X-Rays • 1896 Scipinio Riva-Rocci--Hg sphygmomanometer • 1900 Karl Landsteiner--biocompatibility, ABO system

  8. The danger of touching the heart "Surgery of the heart has probably reached the limits set by Nature to all surgery. No method, no new discovery, can overcome the natural difficulties that attend a wound of the heart." Stephen Paget, 1896 The Surgery of the Chest

  9. Anesthesia for Thoracic Surgery 21 And the LORD God caused a deep sleep to fall upon Adam, and he slept; and he took one of his ribs, and closed up the flesh instead thereof. 22 And the rib, which the LORD God had taken from man, made he a woman, and brought her unto the man. -- Genesis 2

  10. Humphrey Davy--1800 “As nitrous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations…”

  11. Crawford W. Long--1842 Horace Wells--1844 William T.G. Morton--1846 Charles Jackson--1846

  12. Control of the airway But that life may in a manner of speaking be restored to the animal, an opening must be attempted in the trunk of the trachea, into which a tube of reed or cane should be put; you will then blow into this, so that the lung may rise again and the animal take in air. Andreas Vesalius, 1543

  13. John Hunter—1667 • James Curry—1815 • John Snow—1858 • J O’Dwyer—1885 (peroral) • Rudolph Matas—1902

  14. Vascular surgery

  15. Cardiac Catheterization

  16. Heart-lung bypass Von Frey and Gruber--1885

  17. Early Open Heart Surgery With Heart-lung Machine • C.Dennis 1952 2/2 Died • J.Gibbon 1953 5/6 Died • J.Helmsworth 1953 1/1 Died • D.Dodrill 1953 2/2 Died • G.Clowes 1953 2/2 Died • W.Mustard 53/54 5/5 Died 17/18 94.5%

  18. Controlled Cross-circulation3/26/54-7/19/55 • NO. MORT. <2Y MORT. • VSD 28 8(28%) 16 6(37%) • TOF 11 4(36%) 5 3(60%) • CAVC 4 3(75%) 3 2(67%) • IPS 2 0 • 45 15(33%) 24 11(49%)

  19. The price of innovation The more radical (important) the innovation, the greater the ridicule and vilification by colleagues • William Harvey • Ludwig Rehn • Humphrey Davy • Horace Wells • Rudolph Matas • Werner Forssmann • John Gibbon

  20. “I did not repeat the operation because I could not get another case. Although my patient made an uninterrupted recovery, the Physicians declared that it was all nonsense and in fact the operation was unjustified. In fact, it is on no use to be ahead of one’s time.”

  21. PED CARD HX:NADAS

  22. Extracardiac Repair and Palliation • PDA R.GROSS 08/26/38 • COARCT. C.CRAFOORD 10/01/44 • S-P SHUNT BLALOCK-TAUSSIG 11/29/44 • P-A BAND DAMMON-MULLER 1952

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