MO72. Early Historical Innovations in Mitral Valve Surgery Beginning at the Johns Hopkins Hospital
The Johns Hopkins School of Medicine
Baltimore, MD
United States - Contact Me
Emily Rodriguez is a third-year medical student at The Johns Hopkins University School of Medicine. She attended The Ohio State University, where she majored in Chemistry and minored in Substance Misuse and Addiction. Emily has held long-standing interests in the intersections of medicine, science, ethics, and society, fueling her desire to study medicine. During her undergraduate career, Emily was a National Science Foundation Research Fellow, conducting research in a structural biology lab under the mentorship of Konstantin Korotkov. She also spent a year working in public health and harm reduction before beginning medical school.
In line with her desire to have a tangible and immediate impact on those she serves, Emily hopes to pursue a career in adult cardiothoracic surgery. Emily’s research interests include analyzing patient safety metrics, populations-based outcomes and disparities analyses, perioperative care, and quality improvement. She is dually interested in novel cardiac surgical innovations and tracing historical precendents. Emily currently serves as the Director for the Latino Medical Student Association - Northeast and is a member of the Thoracic Surgery Medical Students Association, Women in Thoracic Surgery, Latino Surgical Society, and American Osler Society.
Description
Methods: We conducted an analysis of the Chesney Medical Archives and early editions of the JHH Bulletin. A detailed literature search of MVS was made in the Lancet, Boston Medical and Surgical Journal, and Surgery, Gynecology & Obstetrics through 1920.
Results: In 1905, William Halsted recruited Harvey Cushing in 1905 to lead the Johns Hopkins Hunterian Laboratory, where he worked with residents to establish surgical treatments of MV disease. William MacCallum developed the first cardiac valvulotome and a novel dog model of mitral insufficiency via the first successful attempts to produce valvular lesions via direct exposure of the heart, in 1906. In the same year, Gladys Henry determined the preferred surgical approach to the anterior surface of the heart and achieved improved access to the posterior surface by sternotomy or left thoracotomy. She reported 25 canine experiments with a 44% survival rate. MacCallum showed a trans-apical left ventricular approach was preferable to the trans-auricular approach for accessing the MV due to decreased bleeding. Bertram Bernheim invented a needle for annular ligation, inserted via left thoracotomy, to develop the first animal model of mitral stenosis, conducting a trial of 30 animals, 33% recovering, all with mitral stenosis. He noted progressive annular constriction induced bradycardia, now linked to ischemia induced AV nodal block, a possible complication of MV annuloplasty repair. 14 years before Cutler's commissurotomy, Bernheim and MacCallum confirmed their approach for opening stenotic MVs, stating that "this is a point in favor of the future possible operation on man." After moving to the Peter Bent Brigham Hospital in 1915, Cushing trained Elliott Cutler, who performed the first successful valvulotomy, using the approach developed in the Hunterian Lab.
Conclusions: In the early years of JHH, individuals developed novel animal models, cardiac surgical tools, and surgical techniques that significantly contributed to the development of MVS, laying the groundwork for future advances in surgical therapy for MV disease.
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- MO072 - Early historical innovations in Mitral Valve Surgery beginning at the Johns Hopkins Hospital