Medicine: Blue Babies

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With some misgivings, Johns Hopkins' Surgeon Alfred Blalock made a long incision and exposed the child's beating heart. Then, for three hours he worked at an operation no one had ever done before. The 15-month-old child on the operating table was a "blue baby" and was expected to die. Dr. Blalock believed that he and Dr. Helen Taussig, of the children's hospital at the Hopkins, had figured out how to save blue babies.

A blue baby is so-called because its lips and fingertips are constantly blue; its blood does not contain enough oxygen. A common cause is small or obstructed passages from the heart to the big pulmonary arteries that carry blood from heart to lungs. That is what Dr. Blalock thought he could fix.

With the baby's heart exposed, he could see the great vessels rising from it like pipes from a furnace. He selected a medium-sized artery that normally carries blood to the head and arm, clamped it to prevent loss of blood, cut it through and tied off the useless upper end. The lower end he pulled downward and stitched into a hole he had made in the side of a pulmonary artery, thus bypassing the pulmonary artery's narrow entrance. While he was making the stitches, the left pulmonary artery had to be clamped for half an hour. And all the time the operation was going on, one of the baby's lungs was collapsed.

Finally the surgeon took away the clamps and let the blood flow. Just as he had hoped, it flowed up through the curved artery, around and down into the pulmonary artery and to the lungs. The baby began to breathe more freely. So did Dr. Blalock and Dr. Taussig.

Successful Failure. That first operation was a failure: in a year, the baby died. But the experiment proved that the pulmonary artery can be bypassed.

Last week, after Dr. Blalock had done 65 such operations, he suddenly found himself a hero in the press. Reporters had got wind of the fact that he had saved 80% of his "doomed" patients. All over the U.S., people read about curly-headed Judy Hackman, the Seattle two-year-old who was operated on last fortnight. They read of other blue babies in Maine, Virginia and Indiana, being prepared for a trip to Baltimore by hopeful parents.

Experience has taught Drs. Blalock and Taussig that the best age for the operation is between three and twelve. Under three, arteries are so small they are hard to work with; after twelve, poor circulation may have done permanent brain and lung damage. Before each operation, the surgeons tell the parents that the risks are great. Fathers, they have found, are the timid ones. Mothers usually say to go ahead.