Perfusion History - Midterm

AC-PE

Accreditation Committee - Prefusion Education

• part of CAAHEP

• work with all other perfusion + surgical organizations to establish, maintain and promote appropriate standards of quality for educational programs in perfusion

• 2 representative appointed by each sponsoring organization - 14 members in total

• Consensus Curriculum

AmSECT

American Society of Extracorporeal Technology

• Founded in 1964; worked to professionalize perfusion

• Establish professional environment and field of perfusion → set criteria to be a perfusionist

AACP

American Academy of Cardiovascular Perfusion

• 1979, offshoot if AmSECT → endorses AmSECT Standards and Guidelines

• First meeting in 1980, New Orleans

• Support efforts for advancing perfusion through research, education, and collaboration

ABCP

American Board of Cardiovascular Perfusion

• 1975; Protection of the public through the establishment and maintenance of standards in the field of Perfusion

• Established Examination and Procedures for Recertification

US certification Exams for Perfusion

• 2 part exam: Basic science and clinical application

• AmSECT first administered the certification exam → responsibility was given to ABCP in 1975

Primary Goal for Bypass

Create a Motionless and Bloodless field for safe cardiovascular surgery

Hippocrates

• Described the heart and lungs

• Declared the heart supplied the human body with life

Aistotle

• The heart cannot withstand injury

Galen

• Theory of circualtion linking the heart, liver, and brain

Harvey (1628)

• Theory of Circulation - Father of Cardiology

Galvani

• electrical activity

Bordet (1898)

• Discovered red cell antibody production - Nobel Peace prize

Landsteiner and Weiner

• Landsteiner discovered 3 diffferent blood groups in 1900 - Weiner later discovered the fourth

What is McLean creditited for and when did it occur?

• Medical Student that discovered Heparin in 1915

Lindberg and Carrel (1930s)

• Organ perfusion and transplantation

• Created complex glass perfusion apparatus → perfusion pump

• Successfully kept cat and bird organ alive for 21 days

Werner Forssmann

• First heart catheterization performed on himself

• Won a Nobel Prize

Harken

• removal of foreign bodies from heart

• elective intracardiac surgery during WWII; attempted to remove bullets from mediastinum with magnet

Gibbon

• developed the first heart-lung machine in 1937

• vertical rotating cylinder that caused a thin film of blood to oxygenate

• successful animal perfusion

• First successful CPB use on May 6, 1953

Debakey

• development of roller pump, 1930s

Chargoff and Olson

• discovered that protamine sulfate neutralizes heparin in 1937

Dr. Charles Bailey

Performed first valve surgery in 1940

Dr. Hufnagel

Developed plastic valve to replace aortic valve in 1951

Dr. Starr (1950s)

caged ball valve replacements

First successful Bypass

• May 6, 1953

• Dr. John Gibbon

Walter Lillehei

• 1955, first successful cross circulation surgery using babies father as the donor

• cross circulation in 45 patients

• Azygos Principle in man

DeWall

• developed an inexpensive bypass machine with bubble oxygenator, 1950s

Bubble Oxygenators

• 1960 Commercial bubble oxygenators become available

• developers: DeWall, Lillehei, Clowes, Kloff, Kay and Cross

First Successful CABG

1964 performed by Garrett

First Successful Heart Transplant

• 1967 performed by Barnard

First Total Artificial heart

• 1969 by Dr. Cooley

Three Eras of Perfusion Safety

1. 1950-1960: Perfusion physiology and luck

2. 1970-1980: Improved technology, safety devices

3. 1990-present: human factors, teamwork