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C. Walton Lillehei and the Origins of Open-Heart Surgery

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Black and white photograph of C. Walton Lillehei.

Photograph of C. Walton Lillehei. From the Pioneers of the Medical Device Industry in Minnesota Oral History Project.

Dr. C. Walton Lillehei was a world-famous professor of surgery at the University of Minnesota and an innovator in the field of open-heart surgery. He participated in the world's first successful open-heart operation, developed techniques and devices that made open-heart surgery more successful, and pioneered the use of pacemakers and artificial heart valves.

Clarence Walton Lillehei was born in Minneapolis in 1918. After finishing medical school at the University of Minnesota in 1942, he served in World War II as an army surgeon. He went on to earn a Ph.D. in surgery at the University in 1951 and was recognized as one of the most talented young surgeons at his school.

The 1950s were a time of great excitement and advances in the medical field. The heart in particular fascinated both doctors and the public. Surgeons had shown that problems with blood vessels and defects on the outside of the heart could be successfully repaired. They now dreamed of fixing problems inside the heart as well.

Operating inside a fully-functioning heart, however, was dangerous. Surgeons needed a way to stop blood flow to the heart to work inside it safely. But this was dangerous as well. Without the oxygen carried by blood from the lungs, a patient could suffer brain damage in as few as four minutes.

Some surgeons had tried to create machines that could oxygenate and pump blood to the patient's body and brain instead of the lungs and heart. This would allow them to close off blood flow to the heart, open it up, and repair the inside. The machines, however, were usually expensive and hard to use. Several early patients died due to surgical mistakes and machine malfunctions.

Lillehei and his friend Dr. John Lewis at the University of Minnesota had a different idea. They knew from experiments with dogs that dramatically lowering body temperature also slowed blood flow and reduced the need for oxygen in the brain. In theory, this would give the surgeon more time to operate inside the heart and would not require special machines. On September 2, 1952, Lewis, assisted by Lillehei, used this technique to perform the world's first successful open-heart surgery.

The procedure, however, could not be used in most cases. Lillehei looked for another way to perform heart surgery without complicated machines and decided to try cross-circulation. In this technique, the patient's blood vessels were connected by tubes to another volunteer, the "donor." The donor would supply the patient's blood with oxygen while a simple mechanical pump moved blood between them.

On March 26, 1954, Lillehei used cross-circulation to repair a hole inside thirteen-month-old Gregory Glidden's heart. Sadly, Glidden died of pneumonia eleven days later. Lillehei had shown, however, that his controversial technique could work. Over the next year, he performed forty successful open-heart surgeries using cross-circulation. These surgeries repaired several heart defects that were previously incurable.

Open-heart surgery was still very risky, however. Lillehei continued to search for ways to make it safer and more successful. In 1955, he helped to create a simple and affordable machine that got rid of the need for cross-circulation. He also began working to solve another risk of heart surgery: heart block.

Heart block was a condition in which the heart's rhythm was disrupted during surgery and would suddenly stop. It was dangerous because the problem sometimes was not obvious until after the surgery was finished.

Doctors already knew that the heart reacted to electricity. Lillehei decided electricity might be applied directly to the heart to keep it beating after a heart block. In 1957, Lillehei asked University of Minnesota electrician Earl Bakken for a battery-powered machine that could artificially regulate a heartbeat.

Bakken ended up creating the world's first portable pacemaker. Lillehei successfully implanted this machine in a patient with heart block in 1958. Bakken went on to found Medtronic, now one of Minnesota's most successful companies.

Lillehei also played a key role in developing and implanting the world's first artificial heart valves. Besides his own achievements, he also helped to train more than 150 other heart surgeons from forty different countries. One of his most talented students was Dr. Christiaan Barnard, the South African surgeon who performed the world's first successful heart transplant in 1967.

C. Walton Lillehei died in 1999. In honor of his achievements, the University of Minnesota's heart disease institute is now named the Lillehei Institute.

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Goor, Daniel A. The Genius of C. Walton Lillehei and the True History of Open Heart Surgery. New York: Vantage Press, 2007.

Miller, G. Wayne. King of Hearts: The True Story of the Maverick Who Pioneered Open-Heart Surgery. New York: Times Books, 2000.

University of Minnesota Lillehei Heart Institute. C. Walton Lillehei.
http://www.med.umn.edu/lhi/about/c-walton-lillehei/index.htm

Related Audio

MN90: Opening the Era of Open Heart Surgery | Details

Related Images

Black and white photograph of C. Walton Lillehei.
Black and white photograph of C. Walton Lillehei.
Color photograph of Earl Bakken.
Color photograph of Earl Bakken.
Color photograph of Richard DeWall.
Color photograph of Richard DeWall.

Turning Point

In 1954, Lillehei uses the controversial technique of cross-circulation to perform open-heart surgery on thirteen-month-old Gregory Glidden. Though Glidden tragically died of pneumonia eleven days later, the hole in his heart was successfully repaired. The operation makes Lillehei world-famous as a pioneer in open-heart surgery.

Chronology

1942
Lillehei graduates from the University of Minnesota Medical School and joins the army as a surgeon in a mobile army surgical hospital (MASH) unit.
1945
Lillehei returns to University of Minnesota Medical School as a surgical resident under the supervision of Dr. Owen Wangensteen, chairman of the Department of Surgery.
1951
Lillehei finishes his Ph.D. in surgery and becomes a professor of surgery at the University of Minnesota.
1952
On September 2, Lillehei assists his friend and colleague Dr. John Lewis in performing the world's first successful open-heart surgery.
1953
Dr. John Gibbon performs a successful open-heart surgery in Philadelphia using an artificial heart-lung machine, but these machines are difficult to use and open-heart surgery remains very dangerous. Several surgeons abandon plans for future operations.
1953
Lillehei and his research assistant, Morley Cohen, seize on the idea of using cross-circulation to perform open-heart surgery, and begin experimenting with dogs in their lab.
1954
On March 26, Lillehei performs the world's first successful open-heart surgery using cross-circulation on thirteen-month-old Gregory Glidden. Glidden dies eleven days later, but an autopsy confirms that his heart defect had been successfully repaired.
1954
Lillehei performs two more successful open-heart surgeries. He announces these successes at a press conference and becomes world-famous.
1955
In collaboration with Dr. Richard DeWall, Lillehei helps to develop a simpler heart-lung machine and oxygen bubbler, making open-heart surgery safer.
1955
On December 9, Lillehei performs his 100th open-heart surgery, but the patient dies after surgery due to heart block.
1957
Lillehei asks Earl Bakken, an electrician at the University of Minnesota, to create a portable, battery-powered device to cure heart block by regulating heartbeat using electricity.
1958
On April 14, Lillehei successfully implants the world's first portable pacemaker into a patient with heart block, saving the patient's life.
1967
Lillehei moves to New York to become head of the Department of Surgery at Cornell University Medical Center.
1975
Lillehei returns to Minnesota, but his deteriorating vision causes him to end his surgical career and work more as a teacher, consultant, and writer.
1990
Lillehei dies at his home in Minneapolis. He is remembered as one of the world's foremost pioneers in open-heart surgery.