Comments by Dr. Lillehei

Files in this Data Supplement:

• Video - In this brief video, Dr. C. Walton Lillehei describes how he closed a ventricular septal defect in a child using cross-circulation in 1954. Dr. Lillehei’s narrative was recorded more than 30 years after the depicted operation was performed. One may observe that Dr. Lillehei is closing a sizable ventricular septal defect using interrupted black silk sutures. This was his technique during the first few months that cross-circulation was used for repair of these defects. Forty-five children underwent repair of ventricular septal defect, tetralogy of Fallot, or atrio-ventricular canal using this technique of cross-circulation. Remarkably, reasonably good results were obtained in these children who had their ventricular septal defects closed without a patch. Dr. Lillehei realized early on, however, that a patch would permit a more secure closure of the ventricular septal defect; his first patches were cut from a common Ivalon kitchen sponge. It may be noted in this video that the heart is beating and that no cardiotomy sucker was available at that time. Dr. Lillehei points out in his narrative that “Cross-circulation, utilizing the parent as the oxygenator, was probably the most physiological method of cardiopulmonary bypass, particularly since it was impossible to obtain blood gases, blood pHs, and electrolytes during these open-heart procedures.” Dr. Lillehei goes on to point out that, with no intensive care units, no respirators, and no pacemakers, cross-circulation was probably the only method of cardiopulmonary bypass that would permit successful repair of ventricular septal defects in 1954.--Vincent L. Gott, M.D.