Open heart surgery: results in 600 cases.

The use of extracorporeal circulation during the surgical correction of heart lesions has become generally accepted. Comprehensive discussions of the problems of open heart surgery have been published (Clowes, 1960; Harley, 1960; Allen, 1958). A variety of methods and techniques have been developed for operating on the heart under direct vision, and those that are now in wide use achieve excellent results (DeWall and Lillehei, 1962; Drew, 1961; Gerbode, Osborn, and Johnston, 1960; Molloy, 1961). By the end of 1961 open heart operations for acquired and congenital cardiac lesions had been performed on 600 patients at the University of Michigan Medical Center. A safe, easily controlled procedure for maintaining extracorporeal circulation has been developed which is based on a rotating disc oxygenator and a means for inducing moderate systemic hypothermia. The programme of open heart surgery began in 1957 (Sloan, Morris, vander Woude, Hewitt, and Long, 1959), and the methods now in use represent development throughout the past four years. The risk in open heart surgery to-day is related almost entirely to the severity of the cardiac lesion rather than to the use of extracorporeal circulation. The mortality rate for correction of uncomplicated cardiac defects is less than 1 % in our hands.