Medicine: Historic Operation

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Nothing has been dearer to the surgeon's heart than the dream of a machine to replace the heart—by pumping a patient's blood during an operation. To be thoroughly effective, it must also do the work of the lungs and oxygenate the blood. Only with such equipment could the surgeon perform delicate operations with the heart in his hand, in full view, and with no blood flowing through it. Last week Philadelphia's Dr. John H. Gibbon Jr. made the dream a reality.

His patient, Cecelia Bavolek, 18, a freshman at Wilkes College in Wilkes-Barre, Pa., was not yet born when Dr. Gibbon began the painstaking job of designing and testing equipment which ultimately led to last week's historic operation. Cecelia had a heart murmur which got worse. Her trouble was diagnosed as a hole in the wall between the two upper quarters (auricles) of her heart. Each minute this caused several quarts of blood returning from her lungs to be promptly shunted back there, wasting a lot of her heart's energy.

Oxygen Added. When Cecelia was in high school, Dr. Gibbon had brought his machine along to the point where the heart part worked fine on dogs. But he was still not ready to try it on a human patient (TIME, Sept. 26, 1949). Then Detroit researchers described a machine which had done part of the work of a man's heart, but not his lungs (TIME, Oct. 27).

By last week Dr. Gibbon was satisfied at last with both the heart and lung sections of his machine. At Philadelphia's Jefferson Hospital, Cecelia Bavolek was anesthetized and Dr. Gibbon, with two assisting surgeons, laid bare her heart. They opened the two large veins carrying blood to it, and slipped in plastic tubes which drained the blood away to the artificial heart-lung. There, one pump drew in the blood. Another speeded it to an oxygen chamber, where it flowed over a set of metal grids like the plates in a storage battery. Electronic controls kept the flow rate just right, made sure that oxygen was added and carbon dioxide taken away. in exact amounts, and even kept the blood at the proper degree of acidity. A third pump sent the refreshed blood back into an artery above the left side of Cecelia's heart.

A Look Into the Heart. Cecelia and the machine were hooked together for 45 minutes. For 26 of those minutes the machine breathed for her and pumped her blood. In that time, Dr. Gibbon lifted up her heart and opened it so that the aperture (as big as a half-dollar) between the auricles was in full view. He stitched that up with relative ease since he was working in a bloodless "dry field," although Cecelia's heart kept beating because its muscle was getting a full blood supply. Even more important, so was her brain.

Said Dr. Gibbon, too camera-shy to pose with the apparatus: "The machine is not a cure-all for all heart conditions. It will probably be used chiefly on patients born with a deformed heart. It can't help coronary artery disease or hearts crippled by diseases of old age. But now, for the first time, it is possible to look into the heart. It's sort of like drying out a well to do some work at the bottom of it."

Her heart's well refilled, Cecelia Bavolek was due home late this week.