Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

For those caring for the patient with congenital heart disease, the last 50 years of the 20th century was witness to staggering advances in virtually all aspects of pediatric cardiovascular medicine and surgery. The first half of the 20th century was not dormant in this regard. Dr Maude Abbott of Montreal had published her wonderful atlas in 1936 under the auspices of the American Heart Association, a unique compilation of 1000 cases of congenital heart disease.1 Dr Helen Taussig of Baltimore had founded her cardiac clinic at Johns Hopkins and had begun in the 1930s to characterize the clinical and fluoroscopic findings of a wide variety of congenital heart malformations; this material matured into her 2-volume compendium on congenital heart disease published in 1960.2 Dr Robert E. Gross of the Children’s Hospital in Boston successfully ligated the patent arterial duct in 1938, and that signal accomplishment ushered in the era of surgery for congenital heart disease.3 On the basis of her clinical observations that some children with cyanotic congenital heart disease became progressively more cyanotic coincidently with closure of the arterial duct and cognizant of Gross’s benchmark contribution, Dr Taussig traveled to Boston to attempt to persuade him to construct an arterial duct. When he refused, she broached the subject to Dr Blalock at Johns Hopkins. Some years earlier, when in Vanderbilt and with the technical assistance of Vivien Thomas, in an attempt to produce pulmonary hypertension and using the dog as the experimental animal, Dr Blalock constructed an end-to-end surgical anastomosis between the subclavian artery and the pulmonary artery. With Dr Alfred Blalock as the surgeon and the wisdom of his assistant Vivien Thomas, Taussig and Blalock revolutionized the care of the cyanotic child with the construction of the subclavian artery–to–pulmonary artery end-to-side anastomosis, thus augmenting …