心血管外科基础

历 史
• 肺动脉栓塞 • Frederic Trendelenburg in 1908 • Sharp was first to perform pulmonary embolectomy using cardiopulmonary bypass, in 1962
历史
• 心包 • Weill in 1895 and Delorme in 1898 proposed excision of the thickened fibrous pericardium in constrictive pericarditis
体外循环的发展THE EVELOPMENT
• The development of the heart-lung machine made repair of intracardiac lesions possible. To bypass the heart, one needs • a basic understanding of physiology of the circulation, • a method of preventing the blood from clotting, • a mechanism to pump blood, • finally, a method to ventilate the blood
历史
• 心导管
• Although cardiac catheterization is not considered heart surgery, it is an invasive procedure and some catheter procedures have replaced heart operations. Warner Forssmann is credited with the first heart catheterization. He performed the procedure on himself and reported it in Kleinische Wochenschrift. In 1956, Forssmann shared the Nobel Prize in Physiology or Medicine with Andre F. Cournand and Dickenson W. Richards
历史体外循环前的瓣膜手术HEART VALVE SURGERY BEFORE THE ERA OF CARDIOPULMONARY BYPASS
• The first clinical attempt to open a stenotic valve was carried out by Theodore Tuffier on July 13, 1912
First successful intracardiac repairs using cardiopulmonary bypass or crosscirculation
• • • • • • • • • • Congenital aneurysm sinus of Valsalva 1956 Kirklin Congenital aortic stenosis 1956 Kirklin First direct visual correction Aortopulmonary window 1957 Cooley First closure using CPB Double outlet right ventricle 1957 Kirklin Extemporarily devised correction Corrected transposition great arteries 1957 Lillehei Transposition great arteries: atrial switch 1959 Senning
体外生命支持EXTRACORPOREAL
LIFE SUPPORT
• The development of membrane oxygenators in the 1960s permitted longer support. • Donald Hill and colleagues, in 1972, treated a 24-year-old man who developed shock lung after blunt trauma
历史体外循环前的先心病手术CONGENITAL CARDIAC SURGERY BEFORE THE HEART-LUNG MACHINE ERA
• John Streider at the Massachusetts General Hospital first successfully interrupted a ductus on March 6, 1937. The patient was septic and died on the fourth postoperative day. At autopsy, vegetations filled the pulmonary artery down to the valve • On August 16, 1938, Robert Gross, at Boston Children's Hospital, operated on a 7-year-old girl with dyspnea after moderate exercise
THE DEVELOPMENT OF CARDIOPULMONARY BYPASS
• A schematic drawing by IBM engineers of the pump oxygenator they designed and constructed under Gibbon's direction
• Atrial septal defect • Ventricular septal defect • • • • • • • 1953 Gibbon
1953 Lillehei Cross-circulation Complete atrioventricular canal 1954 Lillehei Cross-circulation Tetralogy of Fallot 1954 Lillehei Cross-circulation Tetralogy of Fallot 1955 Kirklin Cardiopulmonary bypass (CPB) Total anomalous pulmonary veins 1956 Kirklin
First successful intracardiac repairs using cardiopulmonary bypass or crosscirculation
• • • • • • • • • • • • • Coronary arterial-venous fistula 1959 Swan Ebstein's anomaly 1964 Hardy Repair of atrialized tricuspid valve Tetralogy with pulmonary atresia 1966 Ross Used aortic allograft Truncus arteriosus 1967 McGoon Used aortic allograft Tricuspid atresia 1968 Fontan Physiologic correction Single ventricle 1970 Horiuch Subaortic tunnel stenosis 1975 Konno Transposition great arteries: arterial switch 1975 Jaten Anatomic correction Hypoplastic left heart syndrome 1983 Norwood Two-stage operationPediatric heart transplantation 1985 Bailey
瓣膜手术VALVULAR SURGERY: CARDIOPULMONARY BYPASS ERA
• The first successful aortic valve replacement was performed by Dr. Dwight Harken and associates in 1960。A caged ball valve was used. • That same year, Starr and Edwards successfully replaced the mitral valve using a caged ball valve of their own design
心血管外科基础
长海医院
• Dr. Daniel Hale Williams, a surgeon from Chicago who successfully operated on a patient with a wound to the chest involving the pericardium and the heart. • 1893 year
历史
• Dr. Ludwig Rehn, a surgeon from Frankfurt, Germany, who performed the first successful suture of a human heart wound. • 1896year • In 10 years,124cases reported • Mortality 60%
历史体外循环前的心脏手术CONGENITAL CARDIAC SURGERY BEFORE THE HEART-LUNG MACHINE ERA
• Dr. Clarence Crafoord, in Stockholm, Sweden, successfully resected a coarctation of the aorta in a 12-year-old boy on October 19, 1944