Ever since medicine began, people have been trying – vainly, until recent times – to give effective treatment for serious heart complaints. The modern assault on the heart began at about the time that Hitler was undertaking his assault on the rest of the world. The year was 1938 and the surgeon was Robert Gross of the Harvard Medical School in Boston. Gross was one of a number of doctors who had been anxious to attempt the surgical treatment of congenital cardiac defects. He had been encouraged by progress made in the important (and often overlooked) field of anaesthesia, which was enabling the surgical team to maintain greater control over the patient’s respiration while the chest was open. For example, in London Ivan Magill gave pre-war surgeons the ability to remove all or part of an infected or cancerous lung while the patient remained satisfactorily anaesthetized. This also gave the surgeons a chance to familiarize themselves with prolonged surgery in the region of the heart. Moreover, great advances had been made in stitching blood vessels together.
Confident that his patients were being well looked after by the anaesthetists, Gross decided to attempt an operation on a condition that had been first described by the great physician, Galen, 800 years before – patent ductus arteriosus. His patient was a seven-year-old child suffering from this inborn defect, whereby blood leaks from the aorta to the pulmonary artery because a channel or duct has remained open (‘patent’) after birth instead of closing up a few hours or days after the lungs have begun to function. This results in a shunt of blood between the aorta and pulmonary artery, which floods the lungs and puts strain on the left-hand side of the heart; if the condition is untreated the child becomes and remains an invalid. It is estimated that, of all the congenital abnormalities of the heart and surrounding vessels, patent ductus accounts for 17 out of every 100 cases, so you can see why Gross’s planned operation had considerable importance for future generations of unfortunate children.
To cut a long story short, Gross managed to tie off the duct, the operation was a brilliant success, and the news of this major advance spread quickly.
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