Cardiology · 1953
First Successful Open-Heart Surgery Using the Heart-Lung Machine
Before May 1953, no surgeon had safely stopped a human heart, operated inside it under direct vision, and restarted it. The few who had tried to correct intracardiac defects under brief inflow occlusion faced narrow time limits and poor visibility. John Gibbon, a surgical resident at Massachusetts General Hospital in 1931, had conceived of an external machine to take over heart and lung function entirely while the heart was opened, after watching a patient die from a pulmonary embolus that surgeons could not reach in time.
Over the next two decades, Gibbon built successive pump-oxygenator prototypes at Jefferson Medical College in Philadelphia, working closely with his wife Mary Hopkinson Gibbon, who helped design and troubleshoot the engineering. Early results in dogs were discouraging, and several human attempts before 1953 failed. The successful case came on May 6, 1953: Cecelia Bavolek, an 18-year-old woman with an atrial septal defect, had her circulation maintained entirely by the Gibbon machine for 45 minutes while he closed the defect under direct vision. She recovered fully.
Gibbon operated on three more patients that year. A second patient with a misdiagnosed defect died on the table, and two infants died shortly after. Shaken, Gibbon suspended his cardiac surgery program and did not resume it. The machine itself, however, had proved the concept. IBM had funded the engineering refinements; the collaboration between a surgeon and an engineering corporation was itself unusual for the era.
John Kirklin and the team at Mayo Clinic took up the work systematically, reporting their first series of eight patients using a modified Gibbon-type device in March 1955. That series established cardiopulmonary bypass as reproducible in other hands and at other institutions. Within five years, surgical correction of tetralogy of Fallot, mitral valve disease, and other structural cardiac conditions became technically feasible.
The heart-lung machine Gibbon proved in 1953 became the foundation on which coronary artery bypass grafting, valve replacement, and repair of complex congenital heart disease were built over the following decades. Cardiac surgery units now perform millions of procedures annually using derivatives of the pump-oxygenator Gibbon and his wife spent twenty years perfecting.
Key People
- John Gibbon — Surgeon who designed the heart-lung machine and performed the first successful case.
- Mary Hopkinson Gibbon — Co-developer of the pump-oxygenator apparatus alongside her husband.
- John Kirklin — Led the Mayo Clinic series that made cardiopulmonary bypass reproducible.
- Cecelia Bavolek — First patient to survive open-heart surgery with the heart-lung machine.
Minnesota Medicine, 1954
Related landmarks
- 1954 · Warfarin introduced for clinical anticoagulation (Cardiology)
- 1958 · First implantation of a permanent cardiac pacemaker (Senning and Elmqvist) (Cardiology)
- 1961 · Factors of Risk in the Development of Coronary Heart Disease (Framingham Heart Study) (Cardiology)
- 1980 · Implantable cardioverter-defibrillator first human implantation (Mirowski) (Cardiology)