Fifty years of cardiac surgery: Innovation, evolution, and revolution in cardiovascular therapies

The evolution of cardiac surgery reflects some of the greatest accomplishments in the history of medicine. Early work, staring with closed procedures on stenotic valves and repairs of traumatic injuries, while considered initially high risk, and challenges were associated with very high morbidity and mortality rates. Despite early concerns that surgery on the heart would never evolve beyond the most basic of procedures, devoted clinicians and researchers, motivated by the inability to help those suffering from what was generally considered untreatable or inherently fatal problems, persisted against much skepticism, failures, and lack of reliable and appropriate technology. However, over the years, with tremendous dedication to advancing the field, therapies for coronary artery disease, structural valve disease, arrhythmias, and heart failure evolved. While many consider “cardiac surgery” a separate field from “cardiology,” as our review of the history will demonstrate, much of the pioneering work done in the operating room – either with or without the use of the heart–lung machine (cardiopulmonary bypass) – set the foundation for further technological developments. The natural progression of such “operative surgical” therapies is to evolve into miniature, minimally invasive, or percutaneous catheter-based intervention. While there are clearly volumes written, and often fictionalized, on many of these topics, a basic understandable of the rich history of cardiac surgery should be of interest to all – especially since it serves as the basis for so much what is currently offered to patients to help extend both the quantity and quality of their lives. The following core competencies are addressed in this article: Patient care, Medical knowledge, Practice-based learning and improvement.