The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 825-832, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Developments in cardiac surgery in Stockholm during the mid and late 1950s
A Senning
In 1951 in our laboratory in Stockholm, we successfully used our
experimental pump oxygenator: the first dogs survived 40 minutes of total
cardiopulmonary bypass with right ventricular cardiotomy. In the same year
extracorporeal circulation was combined with hypothermia (26 degrees to 28
degrees C) to allow lower perfusion flows, thus diminishing blood trauma
and the risk of perfusion complications. To avoid air emboli during
cardiotomies, the heart was "arrested" with electrically induced
ventricular fibrillation (1952). Our standard perfusion technique used
cooling and rewarming with left ventricular bypass, the oxygenator was used
only during intracardiac manipulations and when the right ventricle was
unable to maintain a sufficient pulmonary circulation. Left ventricular
bypass was continued until normal body temperature was reached and the
heart could be weaned off the pump. In July 1954 we successfully extirpated
a left atrial myxoma in our first patient undergoing open heart surgery, a
40-year-old woman, who is still alive today. Other successful applications
of open heart surgery involved resection of a huge left ventricular
aneurysm after infarction in 1955, correction of supracardiac total
anomalous venous return in 1956, and the first hemodynamic correction of
transposition of the great arteries by atrial switch method in 1958. Also
in 1958, the first totally implantable pacemaker was inserted in a patient
with total atrioventricular block to eliminate the infections that occurred
along the percutaneous pacemaker leads. In October 1958, we also operated
on a patient with severe angina pectoris with stenosis of the left anterior
descending and circumflexed arteries and occluded right coronary artery.
Endarterectomy of the left coronary arteries was performed, and the
arteriotomies were repaired with saphenous vein patches.
