History of cardiovascular surgery and its future: A personal review

Abstract

Five decades have passed since I obtained my doctorate of medicine. Soon after graduation I had the chance to become a resident in the regional hospital of Locarno in southern Switzerland and to begin my favorite surgical experience. One night in October 1946 the professor of surgery of the University of Berne, Karl Lenggenhager, was brought to our clinic heavily wounded and unconscious after a mountain accident. The name of Professor Lenggenhager was known to me from the literature as the initiator in the 1930s of the miniheparin prophylactic treatment, a method to prevent postoperative thrombosis and embolism, which I had already introduced in our surgical department in 1945. I was convinced that the eminent, unconscious patient would like to benefit from the same prevention as his own patients in the University Clinic of Berne. The next day, when I made the third intravenous injection of heparin to the now conscious patient, he was surprised and happy to know that his own method of protection had been routinely used for surgical patients in our small district hospital since 1945. Upon my next visit a few hours later, my famous patient made me the offer to become a resident in his own clinic, which I thankfully and enthusiastically accepted. For four decades, I remained at the University Clinic of Berne. It was the same Professor Lenggenhager who, in 1953, helped me to get a fellowship for cardiovascular surgery from the American Swiss Foundation for Scientific Exchange. Our common goal was to obtain a modern and up-to-date cardiovascular unit in Berne. After the first successful closure of a patent duct by Dr. Robert Gross in 1938, astonishing developments in heart and vascular surgery had taken place between 1944 and 1952. In 1944, the same Dr. Robert Gross, in Boston, and Dr. Clarence Crafoord, in Sweden, initiated the