|
Spring 1994Volume 1, Number 1 |
With the publication of the first issue of this newsletter, it is appropriate to look back on the history of heart and lung surgery before contemplating its future. In an exhibit at Yale entitled The Development of Cardiac Surgery 1896-1991, Dr. William L. Glenn ironically recalled Paget's proclamation in his Surgery of the Chest in 1895: "Surgery of the heart has probably reached the limits set by Nature to all surgery. No new method, and no new discovery, can overcome the natural difficulties that attend a wound of the heart." Surely cardiothoracic surgeons who have lived amidst the explosive growth of our field during the past few decades are fairly warned to be cautious, lest our own historical myopia lead us to believe that there is little left to do or that the achievements of the past fifty years will not be eclipsed during the next fifty.
Any rational viewer must conclude that the last 50 years have witnessed a truly revolutionary period of growth in the surgical treatment of heart and lung disease. Developments during this relatively short time have transcended all previous recorded knowledge in this field and positively transformed the lives of countless thousands of patients.
One may wonder why these past fifty years have been so productive. An extraordinary group of men and women have been attracted to the field. Their vision, intelligence, and courage — their boldness that might in other times have been deemed reckless — cannot be denied. They were and are remarkable people — brash explorers of a new frontier. This period has also been a time of great interaction and synergy, when surgical scientists have demonstrated eclectic creativity, borrowing from other scientists outside the clinical arena.
When they realized the radical and dramatically successful technique of replacing the failing heart, Norman Shumway and his colleagues drew upon their own experience in the physiology of cardiac preservation, the evolving biotechnology of the heart-lung machine, advances in electrocardiography for noninvasive diagnosis of rejection, the pharmacology of drugs to treat rejection, and other seemingly disparate lines of investigation. The surgeon, who is closest to the patient, has focused the many divergent beams of scientific light on the compelling and daunting problem of cardiac disease. This multi-disciplinary approach to surgical innovation is now paradigmatic.
The future of heart and lung surgery, based on the pioneering achievements in transplantation during the past twenty-five years, is an exciting prospect. Transcending all conventional heart and lung surgery is the recognition that curative rather than palliative strategies will ultimately supplant many of our current techniques. The advent of improved mechanical hearts and biologic, xenograft hearts and lungs in unlimited numbers will transform heart and lung surgery in ways no less remarkable than those of the last fifty years.
John Baldwin, MD
Yale University
New Haven, Connecticut
Please be aware that medical advice, diagnoses and physician references cannot be obtained from this site.