Pioneer in Heart Surgery

Today is World Heart Day. Till the most recent history, the human heart was too delicate organ to operate on. It might have continued so till date, were it not for World War II.

One of the first surgeons to gain access to the heart was Dr. Dwight Harken, a young U.S. Army surgeon. Many of Harken's patients were young soldiers evacuated from the European front with shell fragments and bullets lodged inside their hearts. To leave the shrapnel in was dangerous, but removing it was almost surely fatal. Harken began operating on animals, trying to develop a technique that would allow him to cut into the wall of a still beating heart, insert a finger, locate the shrapnel and remove it. All of his first 14 animals subjects died. Of the second group of 14, half died. Of the third group of 14, only 2 died. Harken felt ready to try the technique on humans. All of his patients survived, proving that the human heart could be operated upon.

It wasn't long before surgeons began wondering if Harken's technique might be applied to defective heart valves. In 1948, within days of each other, Harken and a Philadelphia surgeon, Dr. Charles Bailey, independently reported on a daring procedure to correct mitral stenosis: a condition where the mitral valve is narrowed and won't open properly. Just as with the soldiers, a small hole was cut in the side of a beating heart and a finger was inserted to find and very carefully widen the narrowed valve. Early results were disastrous, with the majority of patients dying. Gradually, though, surgeons improved their technique and the procedure became quite safe. This kind of blind surgery - or closed heart surgery - spread to hospitals around the world.