The Future of Cardiovascular Surgery.

Cardiac surgery has been a vibrant field since the early pioneering procedures were attempted, became successful, and eventually reproducible. From the successful closure of a patent ductus arteriosus in 1938 and the Blalock-Taussig shunt, discovery and innovation have been the hallmarks of cardiac surgery. Dr John Gibbon’s first clinical use of the heart lung machine in 1953 opened the door to diverting the circulation and oxygenating the blood, making open heart surgery to repair congenital defects and valvular lesions possible. The development of safe myocardial preservation with solutions to protect the heart opened the surgical world to complex prolonged cardiac procedures and made cardiac transplantation feasible. Routine preservation of myocardial structure and function for periods of several hours has been achieved. The future holds dramatic advances that will transform the cardiac surgeon, in part, into an interventionalist with new skills in diagnostic and therapeutic approaches to structural heart disease.