Key result
Mid-20th century engineering and surgical innovations drive cardiopulmonary bypass development to enable safe open-heart operations.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“one of the major milestones of modern medicine”
“Basically, the philosophy before World War II is you couldn't work on the heart without grave risks to the patient”
This historical review highlights the engineering and surgical innovations that led to the successful development of cardiopulmonary bypass, enabling modern open-heart surgery.
Midway through the 20th century, direct open-heart operations were not yet a reality, awaiting safe methods to support the cardiopulmonary circulation during cardiac surgery. The scientific advancements collectively leading to safe cardiopulmonary bypass are considered some of the most impactful advances of modern medicine. Stimulated by the work of physiologists and engineers in the late 19th century, primitive pump and oxygenator designs were the forerunners of major work by DeBakey and others in roller pump design and by Gibbon in oxygenator development. Following Gibbon's historic successful closure of an atrial septal defect in 1953 with his heart-lung machine, it was left to Lillehei and Kirklin to first successfully repair large series of cardiac malformations. The history leading to these historic events and the subsequent evolution of cardiopulmonary bypass machines for short- and longer-term support is filled with engineering and surgical brilliance, daring innovations, and serendipity.
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Holman et al. (2022) conducted a review in Cardiac surgery. Extracorporeal circulation was evaluated. The development of cardiopulmonary bypass machines evolved through the mid-20th century via engineering and surgical innovations, enabling safe open-heart operations.
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