God Panels and Hep B by Gary Grist BS RN CCP Emeritus
In cataloging documents for the AmSECT History Committee, I reviewed a fun and entertaining publication saved from oblivion by Mark Kurusz. It is the program from the 6th annual meeting of the American Society of Extracorporeal Circulation Technicians in 1968. It… Read More
Joseph and the Amazing Technicolor Dreamcoat The Wonderful Variants of Cardioplegia Composition by Thomas N Muziani March 2023
The current plethora of cardio-protective strategies, combined with the evolution in historical parallel performing a myriad of cardiac operations…are essentially an amalgam to the many years involving trial and error. As a result, numerous techniques evolved to obtain a reproducible… Read More
Dr, Mustard’s Macabre Monkey Machine by Gary Grist and Kelly Hedlund
Dr. William Thornton Mustard MD Dr. William Thornton Mustard (1914 – 1987) was uniquely brilliant. At 22 years of age, he was the youngest physician in Canada in 1937. While serving in Europe during WWII, he performed limb salvage… Read More
Swenko by Gary Grist RN CCP Emeritus with Kelly Hedlund MS CCP and the AmSECT History Committee
Gastric Freezing Successful repair of congenital heart lesions in the early 1950s performed by Drs John Lewis and Walton Lillehei using hypothermic inflow occlusion and cross circulation was only possible with support from their surgical chief, Dr. Owen Wangensteen (1)…. Read More
The First “Red Book” By Gary Grist RN CCP Emeritus and Thomas Muziani PA-C CP
The original hard bound book of any note about cardiopulmonary bypass was Heart-Lung Bypass: Principles and Techniques of Extracorporeal Circulation (HLB)(1). The primary author was Pierre M. Galletti MD PhD who was a pioneer in biomedical engineering. Gerhard A. Brecher… Read More
The Evolution of Pre-Primed Circuits…My Experience by Gary Grist RN CCP Emeritus
By Gary Grist RN CCP Emeritus I recently received an inquiry from a manufacturer’s representative asking me about pre-primed ECMO circuits. I have paraphrased his question below. The Question. “I’ve learned that in some institutions it has become common practice… Read More
Part XXVII – Random Thoughts – Standing on Tall Shoulders – The History of Cardiac Surgery – Thomas N Muziani PA-C, CP
“The two most important days in your life are the day you were born and the day you find out why”- Mark Twain A Thought Experiment: In attempting to re-focus on the history of cardiac surgery I discovered a collection… Read More
Part XXVI- Episode 9- Chronic Heart Failure And Myocardial Energetics – Standing on Tall Shoulders – The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“The best physician…is also a philosopher” Claudius Galenus- “Galen”- (200 BC – 129BC) The Failing Heart: Chronic heart failure in 2019 has unfortunately evolved into an extensive medical and therefore societal dilemma. It is now classified as a common disease affecting… Read More
Part XXV- Episode 8- The Art of Reanimation The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“Everyone is a prisoner of his own experiences” Edward R. Murrow- 1953 (1908-1965) Warm Reanimation: Of the three completely disparate phases that encompass global myocardial protection- induction, maintenance and reanimation… the reanimation phase is by far the most invalidated and… Read More
Part XXIV- Episode 7- The Art of Perfusion- The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“Happiness is nothing more than good health and a bad memory” – Albert Schweitzer MD (1875-1965) Prologue: This past month (Dec. 2018) a large group of surgeons invited me to discuss the more subtle nuances of myocardial protection. They were specifically… Read More
Part XXIII- Episode 6- The Art of Perfusion The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“What is to give light must endure burning” Viktor Emil Frankl MD Ph.D. – (1905-1997) “Our whole edifice of myocardial protection has been built on serendipity”- Mark Braimbridge MD (1924-2016) Cardiac surgeon at St Thomas’ Hospital, London, UK and crystalloid-cardioplegia pioneer…. Read More
Part XXII- Episode 5- Poking the Sleeping Giant The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“Often a healing takes place in ourselves as we pray for the healing of others” – Michael E. DeBakey (1908-2008) Prologue: With the reanimation of potassium based cardioplegia in the United States during early 1970… a true renaissance emerged for both… Read More
Part XXI- Episode 4- When One Door Closes- The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“In all chaos there is cosmos, in all disorder a secret order” – Carl Gustav Jung (1875- 1961) Prologue By 1960, the United States cardiac community collectively agreed to abandon the use of potassium based electro-chemical arrest. The chief pharmacist at… Read More
REMEMBERING THE DISC OXYGENATOR by Kelly D. Hedlund MS, CCP
INTRODUCTION When I began my career in perfusion 30 years ago, the hard shell disposable bubble oxygenator was king. Membrane oxygenators were certainly available, but only comprised 20% of the market. By the mid-1980’s however, the use of membranes quickly… Read More
Part XX- Episode 3- Unintended Consequences- The Advent of Myocardial Protection Standing on Tall Shoulders- The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“Two things are infinite: The universe and human stupidity; And I am not sure about the universe” Albert Einstein- 1955 Author’s note: – It is doubtful that Einstein was ever convinced of an infinite universe. Prior to Edwin Hubble’s published… Read More
Part XIX- Episode 2- Necessity- The Advent of Myocardial Protection- Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“Nothing has more strength…than dire necessity”- Euripides “Discontent is the first necessity of progress”- Thomas A Edison Prologue- The synergism incorporating hypothermia with cardiac surgery has been described by many investigators as the single most important advance for protecting the… Read More
Part XVIII- Episode 1 – Buying Time- The Advent of Myocardial Protection – Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
To give pleasure to a single heart by a single act is better than a thousand heads bowing in prayer” -Mahatma Gandhi Prologue- I have received several requests for a more comprehensive backstory on myocardial protection. From my earliest days… Read More
Part XVII Norman E. Shumway- The Dawn of a New Era- Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“A man is but the product of his thoughts. What he thinks, he becomes.” Mahatma Gandhi- All Men are Brothers From Chrysalis Emerge – In 1960, with the new buildings completed, Stanford University Medical Center blossomed in Palo Alto, CA. The… Read More
Part XVI- Norman E. Shumway And The Fruit of Curious Minds- Standing on Tall Shoulders- The History of Cardiac Surgery Thomas N Muziani PA-C, CP With An Ending Note By Mary Ann Overton CCP
“Success has many Fathers…but failure is an orphan” Italian Proverb and favorite quote of President John Fitzgerald Kennedy. Einstein’s thought experiment- “What if?” The day quickly approached when the first cardiac procedures were to commence at Children’s Hospital San Francisco. All… Read More
Part XV- Norman E. Shumway- Standing on Tall Shoulders-The History of Cardiac Surgery By Thomas N Muziani PA-C, CP With An Ending Note By Mary Ann Overton CCP
“A kind gesture can reach a wound that only compassion can heal”- Steve Maraboli Author’s note:Through a series of totally unrelated events over the last several weeks I have witnessed several very close friends, in the words of the Nez… Read More
Part XIV- Dr. Leonard Bailey & Baby Fae – Standing on Tall Shoulders The History of Cardiac Surgery Thomas N Muziani PA-C, CP
Because I could not stop for Death…He kindly stopped for me… The carriage held but just ourselves…And immortality Emily Dickinson 28 July- 12 August 1984- The 1984 Summer Olympics, officially known as the Games of the XXIII Olympiad, were being… Read More
Part XIII- Dr. Leonard Bailey & Cross-species Transplantation – Standing On Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“Success is not final, failure is not fatal: it is the courage to continue that counts” – Winston Churchill In the late 1970’s and early 1980’s, the serendipitous revelation that Leonard Bailey and his team of researchers could resolve their immunosuppression… Read More
Part XII- Cross-species Organ Transplantation – Standing On Tall Shoulders The History of Cardiac Surgery Thomas N Muziani PA-C, CP
“Medicine is magical and magical is art- Thinking of The Boy in The Bubble- And the Baby with the Baboon Heart”- “The Boy in the Bubble”- Graceland- Paul Simon-1986 Late in the evening of 23 January 1964, in an operating… Read More
Part XI – Dr. René Geronimo Favaloro & CABG – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“I am a slow walker…but I never walk back” – Abraham Lincoln During the 1960’s, the United States was experiencing an explosive transformation. Post World War II had provided, for the very first time in history, a true middle class. The… Read More
Part X – Dr. James D. Hardy MD – Standing on Tall Shoulders – The History of Cardiac Surgery 10 by Thomas N Muziani PA-C, CP
“Man is a clever animal who behaves like an imbecile” – Albert Schweitzer 1960’s – The age of organ transplantation There is an age old expression, attributed to New York Senator William L. Marcy in 1828: “To the victor belongs… Read More
Part IX – Valves And Veins – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“Innovation distinguishes between a leader and a follower” – Steve Jobs 1960-1970- The advent of prosthetic heart valves and coronary artery bypass surgery With the general acceptance and practical utility provided by extracorporeal circulation, innovation in cardiac surgery blossomed, analogous… Read More
Part VIII – Richard Jensen (1938-2009) – Standing on Tall Shoulders – The History of Cardiac Surgery
FROM COUNCIL BLUFFS, IOWA TO HUTCHINSON, MINNESOTA—MAPLEWOOD ACADEMY TO THE UNIVERSITY OF MINNESOTA Early one day, I walked over to the University of Minnesota to sign up for pre-med. While waiting, I picked up the school newspaper and saw an… Read More
Part VII – Dr. Richard DeWall and Bubbles – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“I say there is no darkness…but ignorance.” –William Shakespeare Walt Lillehei’s research lab in the basement of University of Minnesota felt like Penn. Station with the superfluity of activity. Richard DeWall had become fully engrossed in attempting to create a… Read More
Past VI – Dr. Walton Lillehei’s Second Plan – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“The Pendulum of the Mind Oscillates between Sense and Nonsense- Not between Right or Wrong” Carl Gustav Jung Walton Lellehei had become exceedingly cognizant of the general mood displayed by physicians and researchers proclaiming “we have progressed as far as we… Read More
Part V – Drs. Gibbon and Lellehei – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“What mankind can dream-research and technology can achieve” Walton Lillehei Dr. John Gibbon had completed his full 4 year term of active duty service during World War II and now he was able to return to Mary and their animal… Read More
Part IV – Closing Atrial “Loop Holes” – Standing on Tall Shoulders – The History of Cardiac Surgery by Thomas N Muziani PA-C, CP
“A successful surgeon should be a man who, when asked to name the three best surgeons in the world, would have difficulty deciding on the other two” -Denton Cooley 1952-1954: The Dawn of Open Heart Surgery True open heart surgery… Read More
Part III – Blalock, Taussig and Vivian Thomas – Standing On Tall Shoulders The History of Cardiac Surgery – by Thomas N Muziani PA-C, CP
“Knowledge comes, but wisdom lingers”- Alfred Blalock, 1944 Synergy- “The interaction of elements that, when combined, produce a total effect that is greater than the sum of the individual elements”. There are times throughout history that we can bear witness to… Read More
Part II – Truly Remarkable Decades – Standing on Tall Shoulders The History of Cardiac Surgery – by Thomas N Muziani PA-C, CP
“I want to know God’s thoughts…all the rest are details.” Albert Einstein 1907 A small issue of extreme importance must be kept in context with regard to the invasive nature of cardiac surgery during the period of 1907 and before…. Read More
Part I – A Remarkably Young Story – Standing On Tall Shoulders – The History of Cardiac Surgery by Thomas N. Muziani PA-C, CP
“The more extensive a man’s knowledge, of what has been done, the greater will be his power of knowing what to do.” Benjamin Disraeli 1804-1881, Prime Minister of the United Kingdom and Great Britain “Those who cannot remember the… Read More
The Northridge Earthquake 1994: A Tale Of Two Perfusionists
The recent earthquakes in Japan (April 15, 2016, 7.0 magnitude) and Ecuador (April 16, 2016, 7.8 magnitude) brought back the grim reminder of how fragile life is. From the death toll to the devastation of property, you may think you… Read More
The Evolution of Cardiac ECMO at One Hospital by Gary Grist RN CCP Retired- August 2012
Open heart surgery using cardiopulmonary bypass (CPB) began in 1953. It was used to repair congenital heart defects, mostly in children, because patients with congenital heart disease rarely lived into adulthood. In the 1960’s that changed when coronary artery… Read More
Neonatal ECMO: My First Experience by Gary Grist RN CCP Retired
The first time I heard the word ‘ECMO’ was in 1985. Dr. Ron Howard MD, one of the pediatric surgeons, mentioned that he would like to have an ECMO program to support his congenital diaphragmatic hernia patients who frequently died… Read More
“The First Perfusionist I Ever Met” By Gary Grist RN CCP Retired
The first perfusionist I ever met was a guy named Jerry Swett. In 1968 when I was 19 years old and after a year of being a hospital orderly (and going to college classes around my work schedule), I started… Read More