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History of Perfusion

History of Perfusion. Brian Schwartz, CCP September 2, 2003 Perfusion I. Introduction. Before 1952 Physicians had no means of treating patients with intracardiac malformations

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History of Perfusion

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  1. History of Perfusion Brian Schwartz, CCP September 2, 2003 Perfusion I

  2. Introduction • Before 1952 Physicians had no means of treating patients with intracardiac malformations • With the development of the heart and lung machine, surgeons were able to operate on patients who were once considered “non-operatable”

  3. Historical Time-Line • 1952: Lewis performed the first open heart surgery (repair of an ASD). • Used inflow occlusion and general hypothermia • 1953: Gibbon performed many cases utilizing CPB; yet he only had one success • 1954: Lillehei used “cross-circulation” for the closure of a VSD

  4. Historical Time-Line (cont) • Late 1950’s: Kirklin used the film oxygenator in a large number of patients • May of 1955: The DeWall-Lillehei bubble oxygenator became the method of choice to oxygenate venous blood during open heart surgery • Membrane oxygenator developed and used from the 50’s to the 70’s

  5. Historical Time-Line (cont) • 1980’s: Design changed with regards to the membrane oxygenator…now microporous, making it the choice of oxygenators • Priming the heart and lung machines with non-blood solutions was a major advance in heart sugery • Improved tissue perfusion • Reduced hemolysis • Avoided exposure to donor blood

  6. Reasons Why Initial Results were Discouraging • Flow rates were too high • Poor visibility • Pumping air to patient

  7. Controlled Cross-Circulation for Cardiopulmonary Bypass • The thought of using “cross-circulation” for cardiac surgery led to huge debates within the medical community • With this method physicians used a “normal human being” to provide donor circulation • This technique for ECC was utilized for 45 operations, with no donor mortality/morbidity.

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