高级外科学PPT-胸心外科进展

Mitral valvulotomy using finger
Mitral valvulotomy using teratomy knife
BEFORE CPB
BlalockTaussig Operation
1945
1946
Anomalous coronary artery
Aortopulmonary
─ Dr. Ludwig Rehn
CARDIOPULMONARY BYPASS
CPB
“ To bypass the heart, one needs a basic understanding of physiology of the circulation, a method of preventing the blood from clotting, a pump to pump blood, and finally a method to ventilate the blood .”
window
1948
1951
Transposition of the
pulmonary veins
Clenn shunt
1958
Congenital Cardiac Surgery
BEFORE CPB
John Streider interrupted a ductus in 1937
Clarence Crafoord resected a coarctation of the aorta in 1944
1912
1923
Mitral stenosis teratomy
knife
Mitral valvulotomy using finger
1925
1947
Pulmonary valvulotomy
Multiple valvular disease
1952
Heart Valve Surgery
BEFORE CPB
Billroth
BILLROTH
“No surgeon who wished to preserve the respect of his colleagues would ever attempt to suture a wound of the heart.”
─ Billroth’s Spell
McLean described his finding in February 1916 at a medical society meeting
CPB
John Gibbon
John Gibbon contributed more to the success of the development of the heartlung machine than anyone else
INTRODUCTION
INTRODUCTION
Heart
Pericardial cavity
Mediastinum
INTRODUCTION Our Heart
HISTORY
BILLROTH
The most famous surgery worldwide
Billroth's operation I Billroth's operation II
Currently, it is estimated that more than one million cardiac operations are performed each year worldwide with the use of the heart-lung machine.
MYOCARDIAL PROTECTION
─ C. Walton Lilleheiຫໍສະໝຸດ Baidu
HEPARIN
Jay McLean
One of the key requirements of the heart-lung machine was anticoagulation
Heparin was discovered in 1915 by Jay McLean, a medical student working in the laboratory of Dr. William Howell
Alexis Carrel reported in 1914 that it was possible to clamp the pedicle of the heart (aorta and pulmonary artery) for two and a half or three minutes without any subsequent trouble.
HEART OPERATION
Performed what many consider the first successful heart operation in 1896
Dr. Ludwig Rehn
HEART OPERATION
“I hope this will lead to more investigation regarding surgery of the heart. This may save many lives.”
Gibbon's work on the heartlung machine took place over the next 20 years
CPB
Gibbon reported the first successful demonstration in 1937
CPB
The first successful right-sided heart bypass was carried out on October 21, 1952
A 16-year-old boy with congenital pulmonary stenosis had been performed a pulmonary valvuloplasty under direct vision
CPB
BEFORE CPB
Stenotic aortic valve
BEFORE CPB
The famous Blalock-Taussig operation in 1945
BEFORE CPB
Glenn Shunt
CURRENT SITUATION
By the end of 1956, many university groups around the world had launched into open heart programs.