ASTSA Fall 2017

three atrial septal defect – the first total cardiopulmonary bypass. This innovation enabled successive generations of sur- geons to operate on millions of human hearts with positive outcomes, resulting in the correction of congenital heart defects, cardiac valve disorders, atherosclerotic artery obstruction and large aneurysm of the thoracic aorta. Before his ground-breaking achievement, cardiac sur- gery was in its early stages. Gibbon had to work through every aspect of artificial circulation: how the blood could drain from the body, how to pump blood back into the body, how to clear air from inside of the heart, and how to anticoagulate success- fully without producing clots in the equipment. In the early 1950s, he de- veloped a design in conjunc- tion with IBM. This model consisted of a screen oxygen- ator that permitted blood on both sides of the screen mesh to interface with oxygen, and three roller pumps modi- fied from Michael DeBakey’s transfusion pump, to pump blood back into the body. After the first successful surgery in 1953, Gibbon per- formed the procedures twice more on young children, who subsequently died. Never again did he perform the surgery. The Mayo Clinic had requested the design of his oxygenator, which he shared that same year. Mayo physicians continued to develop the oxygenator, increasing its success rate. Gibbon decided to return to practicing thoracic surgery. He continued as professor and chair of surgery at Jefferson and served as president of the American Surgical Associa- tion in 1954. Gibbon retired in 1967 and suffered from a fatal heart attack in 1973. ohn H. Gibbon, Jr., a fifth-generation physician, was born in Philadelphia in 1903. He graduated from Princeton University at the age of 20 and received his doctor of medicine degree from Jefferson Medical College four years later. Gibbon completed his internship in 1929 and began a research fellowship at Harvard in the early 1930s with Edward Churchill, MD, chief of surgery at Massachusetts General Hospital. One day a patient collapsed from a massive pulmonary embolism after surgery and underwent a closed pulmonary embolecto- my. While he watched, the pa- tient’s condition deteriorated and the patient died, leaving a lasting effect on Gibbon. In Boston, he conceived the idea that a device could fulfill the functions of the body’s heart and lungs. He wanted to design a machine that could interrupt the heart’s circula- tion and function so that doctors could remove a clot from pulmonary circulation and then go on to restore the patient’s normal hemodynam- ics. Over the next few years, Gibbon developed his idea and began to experiment, initially in Boston and later at the University of Pennsylvania. When World War II began, Gibbon served in the Army in Asia. After the war, he continued his academic career at Jefferson Medical College as a professor of surgery and director of surgical research. In 1953, he successfully repaired a defect in the heart of a female patient. She was connected to the pump oxy- genator for 45 minutes. During that interval, the machine completely supported all of the patient’s respiratory and cir- culatory functions, while he repaired her large secundum J H I S T O R Y O F S U R G E R Y JohnH. Gibbon, Jr. References 1. Cohn LH. Fifty Years of Open Heart Surgery. Circulation. 2003;107;2168-2170. DOI: https://doi.org/10.1161/01. CIR.0000071746.50876.E2. Accessed 11-16-17. 2. Angelo FM. "Dr. John H. Gibbon, Jr. and Jefferson's Heart-Lung Machine: Commemoration of the World's First Successful Bypass Surgery," [poster] 2015; http://jdc.jefferson.edu/jeffhistoryposters/1. Accessed 11-16-17. Reprinted from the January 2006 issue of The Surgical Technologist. Charcoal Portrait by Dave Ludwig