using cardiopulmonary bypass, she lived another forty-seven years before
dying at age sixty-five.^2 Sadly, Gibbon’s next three patients all died in the
operating room (or shortly thereafter). It had taken nineteen years of
laboratory research, with countless animal operations and endless hours of
investigation to develop the machine, but by 1954 he decided to suspend
all open-heart operations for at least a year while attempting to improve
outcomes. It must have been a crushing defeat for Dr. Gibbon; in fact, he
never performed another open-heart operation again.^3
The surgeons in Minneapolis were working on their own
cardiopulmonary machine (with little progress) and also innovated with
biological solutions. In early 1954, during a brainstorming session among
clinicians, one of the young surgeons reflected on his pregnant wife’s
ability to support her fetus with blood flow to the womb, and the idea of
“cross-circulation” was born. The team investigated the ability of a dog to
function as an external, biological, cardiovascular machine to keep another
dog alive during surgery. After dozens of sham dog operations, Dr. Walton
Lillehei at the University of Minnesota performed an operation on a one-
year-old boy who was connected to his father, who served as a “biologic
oxygenator.” One can only imagine the anguish of a mother watching her
husband and child wheeled away on gurneys to the operating room for the
cross-circulation operation, or the gallantry of a father placing his own life
at risk while sustaining his infant son. The “general discouragement about
open-heart surgery changed drastically”^4 that day, even though the young
patient succumbed to pneumonia eleven days later. Undeterred, Lillehei
and his team performed forty-five operations over the next year using
cross-circulation, each time the pediatric patient being sustained and saved
through a parent (who risked their own life), with two thirds of the patients
surviving surgery and being discharged from the hospital. Major cardiac
defects were treated, including atrial and ventricular defects (“holes in the
heart”), and even tetralogy of Fallot. A year earlier, these conditions were
unqualified death sentences. After a year’s experience, in 1955 (a decade
after Alfred Blalock’s original blue baby operation), Dr. Lillehei presented
his data on the first tetralogy of Fallot patients, with Blalock in the
audience in Philadelphia at the American Surgical Association meeting.
In the ten-patient series, six had excellent outcomes, but four died, all
within hours of surgery. Such a failure rate would not be tolerated today,
but in 1955 this was nothing short of a triumph. Dr. Blalock commented