after Walton Lillehei read his paper, “I suspect it’s a mistake for an old
conservative surgeon to discuss this paper. I must say I never thought I
would see the day when this type of operative procedure could be
performed. I want to commend Dr. Lillehei and Dr. Varco and their
associates for their imagination, their courage, and their industry.”^5
Occasionally, in science, a groundbreaking presentation in a darkened
conference center is given, and the magnitude of the moment is
comprehended by every colleague in the room. Like aerospace engineers
embracing and waving flags after a successful rocket launch, the surgeons
in that room in Philadelphia were no doubt wiping away tears of joy, and
were energized with a renewed optimism. Thirty years later at the 1985
meeting of the Society of Thoracic Surgeons, Dr. Lillehei presented the
long-term results of those forty-five patients. Remarkably, seventeen of
his twenty-seven patients who suffered from ventricle septal defects were
still alive, a stunning finding in light of the impossibility of their survival
without surgery. Dr. Denton Cooley, one of the great pioneering surgeons
in the history of the art, spoke from the podium afterward, saying, “Dr.
Lillehei provided the can-opener for the largest picnic thoracic surgeons
will ever know.”^6 While cross-circulation cardiopulmonary support was
only briefly used, it ushered in the ability to perform open-heart surgery,
and by the end of the 1950s, surgeons around the world were inspired to
consider the impossible ... maybe nothing was impossible.
Walton Lillehei and his team demonstrated that serious cardiac defects
were treatable, reigniting a quest to perfect the mechanical
cardiopulmonary machine. The Gibbon machine, modified at the Mayo
Clinic, was considered too costly for practical use, and Dr. Lillehei turned
to his young crew of lab assistants to develop a better machine. The chief
architect was Richard DeWall, a recent medical school graduate who
envisioned a life of research and laboratory medicine. Starting with a
clean slate, DeWall became the “MacGyver of medicine”^7 by assembling a
“Rube Goldberg” contraption of twisted hoses, pumps, needles, and
oxygen tanks. Instead of fragile glass tubes, DeWall used polyvinyl hoses,
which had the dual advantage of being cheaper and surprisingly less
reactive with blood than glass was. His shoestring budget actually became
an advantage, energizing an openness to the polymer revolution; the
polyvinyl tubing for pumping mayonnaise had come from a nearby
factory.