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1628

Around 1600, an old model of the blood system still held sway. William Harvey (1578-1657) published his "Exercitatio anatomica de motu cordis et sanguinis in animalibus" (An Anatomical Essay Concerning the Movement of the Heart and the Blood in Animals) in 1628, revising outdated understandings. Contrary to earlier work, Harvey concluded that the heart's beating, rather than an intrinsic "pulsative virtue" of the blood vessels, was responsible for the pulsing of arteries. More importantly, whereas earlier models of the blood system asserted that blood was continuously absorbed by the body and replaced by the liver, Harvey's experiments showed that more blood flowed through the heart in one minute than could possibly be created by the body in the same amount of time. In other words, rather than being absorbed immediately, blood flowed in a continuous circuit through the heart, lungs, and body.

1801

Francisco Romero, a little-known Spanish surgeon, performed one of the first cardiac surgeries. Called an open pericardiostomy, the procedure involves cutting an opening into the pericardium, the protective sack around the heart. The procedure was considered too aggressive, and his work was silenced for many years.

1896

In Frankfurt, Germany, Dr. Ludwig Rehn stitched a wound in the heart of a young German soldier, performing the first successful heart surgery on a living person without any complications.

1899

Two Swiss physiologists first performed the process of defibrillation on a dog's heart, demonstrating that while small electrical shocks can induce fibrillation, a shock of greater strength can restore normal heart muscle rhythm.

1910

Alexis Carrel devised a method to allow organs to survive while they are out of the body as well as an idea for performing shunt procedures between chambers of the heart. His research and findings were critical to the advancement of open-heart surgery, organ transplant, and the Blalock-Taussig Shunt, a procedure is temporarily used to direct blood flow to the lungs when treating heart defects for blue-baby syndrome. His research would win him a Nobel Prize two years later.

1929

A young surgical resident named Dr. Werner Forssman experimented on himself by inserting a catheter into his own vein. This groundbreaking method would prove to be a safer way to inject drugs directly into the heart. Unfortunately, because of his self-experimentation, Forssmann was fired from his job and branded crazy by the medical establishment.

1938

Dr. Robert Edward Gross at the Children's Hospital in Boston performed the first operation for patent ductus arteriosus, a congenital heart defect in which the ductus arteriosus, a special blood vessel in the fetus that allows circulation to bypass the lungs and go directly to the aorta, fails to close normally around 15 hours after birth. His patient was a seven-year-old girl named Lorraine Sweeney. Gross and Dr. John Perry Hubbard worked on dogs and other animals in order to perfect the procedure for use in humans.

1947

The defibrillator was used for the first time by Dr. Claude Beck, a professor of surgery at Western Reserve University, on a 14-year-old boy receiving an operation for a congenital heart defect. Beck theorized that heart muscles twitching at random rather than in unison could happen in healthy hearts.

1950

The first artificial heart valve, a caged-ball valve, was implanted by Dr. Charles Hufnagel, paving the way for the dependable heart valves of the future. Out of 10 patients implanted with the devices, six survived.

1952

Dr. C. Walton Lillehei and Dr. F. John Lewis used hypothermia to temporarily slow the heartbeat of a five-year-old girl before performing a surgical repair to a hole in her heart, demonstrating the possibility of open-heart surgery. Because hypothermia limits the amount of time for surgery, this method failed to gain widespread popularity.

1953

a. The first cardiac surgery using local anesthesia was conducted by Soviet surgeon Aleksandr Aleksandrovich Vishnevskiy.

b. Dr. John Gibbons invented the first practical heart-lung machine. Allowing open-heart surgeons to circulate blood while operating, this machine acts as the heart and keeps patients alive while the doctor operates.

1954

a. After a blackout in the Twin Cities, Dr. Earl E. Bakken designed the first wearable, battery-powered, transistorized cardiac pacemaker at the request of Dr. C. Walton Lillihei at the University of Minnesota.

b. The first cross-circulation operation was performed by Dr. C. Walton Lillihei. The one-year-old patient had the 0+ blood type, and so did his father. In the cross-circulation technique, the father was connected to the child and provided oxygenated blood to the child's body during surgery. This landmark surgery helped to generate hope in the medical community regarding open-heart surgery for complicated congenital heart defects, such as ventricular septal defect (VSD).

1958

A pacemaker was implanted into a human at the Karolinska University Hospital in Sweden, failing after three hours. In a second attempt, the pacemaker lasted two days.

1964

Dr. James D. Hardy of the University of Mississippi in Jackson attempted the first heart transplant from a nonhuman primate -- a chimp named Bino -- into a human. The patient was 68-year-old Boyd Rush. After only 90 minutes, the heart stopped functioning because it was too small to maintain circulation on its own.

1967

a. Dr. Rene Favaloro used a vein from the leg to bypass a blocked coronary artery. This procedure, known as coronary artery bypass surgery, is performed roughly 500,000 times each year in the United States.

b. The first human heart transplant was performed in Cape Town, South Africa. Dr. Christiaan Barnard removed the heart of a 25-year-old woman who had died after an auto accident and placed it into the chest of a 55-year-old man dying of heart damage. Unfortunately, the drug used to prevent the patient's immune system from rejecting the new heart also impaired the patient's ability to fight off other illnesses. The patient died of pneumonia 18 days later. The transplant brought worldwide notoriety to Dr. Barnard and his procedure.

1974

Andreas Gruentzig performed the first peripheral human balloon angioplasty, a procedure that widens a narrowed or blocked artery by inserting and expanding a deflated balloon to open the blocked area. This procedure, a less invasive method of clearing clogged heart arteries than open-heart surgery, gained popularity.

1980

The first ICD -- weighing 9 ounces and about the size of a deck of cards -- was implanted into a human patient. First conceived in 1960 by Polish-born doctor Michel Mirowski after his mentor died of a heart arrhythmia, the ICD was developed as an alternative to drugs and surgery for the treatment of arrhythmia.

1982

The first permanent artificial heart, called the Jarvik-7, designed by Dr. Robert Jarvik, was implanted into a 61-year-old retired dentist. Because the Jarvik-7 was kept beating by an external compressor attached by hoses, the patient was required to remain immobile. The patient survived for 112 days after the device was implanted.

1986

The first stent was inserted into a human coronary artery in Toulouse, France by Jacques Puel and Ulrich Sigwart. The stent, a small metal tube or "scaffold," is inserted into the artery during an angioplasty to keep the artery open after the balloon has been pulled out.

1994

The FDA approved the Palmaz-Schatz Balloon-Expandable Stent as a medical device to unblock and keep open obstructed heart arteries. The unexpanded stent is mounted over an angioplasty balloon and moved into position inside a blockage site using a catheter. When the balloon inflates within the artery, the Palmaz-Schatz stent expands with it. Then, after the balloon is removed, the stent remains permanently in place. This was the first stent approved by the FDA.

2001

The future of robotic heart surgery seemed promising after an issue of ANNALS OF SURGERY printed encouraging results from the first pilot study. Robotically assisted surgery puts the surgeon behind a computer console directly manipulating robot arms that operate on the patient. This enhances the surgeon's ability to perform delicate maneuvers and precise incisions and stitches, even allowing for the surgery to be performed from miles away.

2003

The FDA approved the first drug-eluting stent. This technological breakthrough slowly releases medicine to prevent the artery cell walls from growing around the stent and reblocking the passage.

2007

In a study published in the January issue of the journal CIRCULATION RESEARCH, researchers at Technion-Israel Institute of Technology reported creating new heart muscle tissue using human embryonic stem cells. The tissue, complete with its own blood vessels, could eventually be used to replace damaged cardiac tissue after a heart attack. The muscle was created from a three-dimensional, sponge-like plastic scaffold, which was then seeded with heart muscle cells and blood vessel cells produced from stem cells.