C. WALTON LILLEHEI, M.D., PH.D. 1918 - 1999

"One of the unsung heroes of cardiac surgery of the twentieth century"Lillehei the Educator

Between 1951 and 1967, Lillehei trained 136 cardiac surgeons at Minnesota and 20 more at Cornell-a total of 153 surgeons. A number of these surgeons then headed their own cardiac training programs. Remarkably, more than 800 surgeons from 35 countries can directly trace their training lineage back to Lillehei. It was this group of cardiac surgeons who organized the C.Walton and Richard C. Lillehei Surgical Society in 1986.

Dr. C. Walton Lillehei died at his home in St. Paul, Minnesota on July 5, 1999. He was 80 years old and the cause of death was cancer.

Dr. Lillehei is generally considered as the individual who initiated the whole field of open heart surgery with his landmark intraventricular operations in 1954 and 1955. Dr. John F. Lewis had closed simple atrial septal defects using immersion hypothermia in 1952 and Dr. John H. Gibbon, Jr. had successfully repaired an atrial septal defect in 1953 in one patient using a screen oxygenator. Progress in open heart surgery was totally stalled following Gibbon's successful operation by repeated failures with pump oxygenators and by the widespread acceptance of the "sick human heart" theory. Most authorities at the time felt that open heart surgery would be impossible without an artificial heart to support postoperative recovery. This then was the atmosphere of despair existing when cross-circulation so startled the medical world by repeated successes in very sick patients with complex intraventricular lesions. These successes with cross-circulation, as developed by C. Walton Lillehei, virtually overnight changed widespread pessimism to one of optimism for the future of open heart surgery. Dr. Lillehei and his team first repaired a ventricular septal defect at the University of Minnesota on March 26, 1954.

First cross-circulation case to repair ventricular septal defect March 26, 1954 - University of Minnesota Hospital, Minneapolis, Minnesota. Dr. Lillehei is on patient's left with headlight, Dr. Richard Varco is first assistant across table. Arterial and venous cannulae from father's groin seen on right.

During the next fifteen months, 45 patient with major intracardiac malformations, not previously correctable, underwent repair utilizing cross-circulation between the patient and parent. These first successful operations by Dr. Lillehei for complicated intracardiac congenital defects initiated the whole field of open heart surgery as we know it today.

Because Dr. Lillehei was the only surgeon in the world operating on these complicated intracardiac defects using cross-circulation, he was able to use the opportunity to develop many other new techniques and devices to permit a more successful outcome for these patients. Heart block was a major cause of death in the initial patients undergoing repair of ventricular septal defects; Dr. Lillehei then developed a technique of direct myocardial stimulation with an external pacemaker and a myocardial electrode. The first human use of this pacemaker system by Dr. Lillehei occurred on January 10, 1957 at the University of Minnesota Hospital. Dr. Lillehei also initiated research on the use of a small portable external pacemaker for these patients with heart block. This ultimately led to the development of the billion-dollar pacemaker industry. Working with Dr. Richard A. DeWall, Dr. Lillehei developed the first clinically successful bubble oxygenator which supplanted the use of cross-circulation in 1955. The availability of the simple Lillehei-DeWall oxygenator allowed for tremendous growth of open heart surgical programs the world over.

With the early availability of the Lillehei-DeWall oxygenator, Dr. Lillehei pioneered the surgical management of acquired valvular heart disease. For the first time, regurgitant valves could be repaired and stenotic lesions could be opened more completely and precisely. At the same time, diseased valves that defied reconstruction were encountered that stimulated laboratory research to invent artificial valve replacements. There have been several mechanical heart valves designed and developed in Dr. Lillehei's laboratory that have been commercially manufactured for clinical use. These include the Lillehei-Kaster pivoting disk valve and the Kalke-Lillehei bileaflet cardiac valve that was the forerunner of the St. Jude valve.

Dr. Lillehei expanded his contributions to medical science with the training of 134 cardiothoracic surgeons at the University of Minnesota Hospital and an additional 20 surgeons at the Cornell Medical Center. Trainees came from all areas of the world and included Dr. Norman Shumway who later devised the surgical technique for heart transplant operation, Dr. Christian Barnard who performed the first successful heart transplant operation in 1967 and Dr. Richard DeWall with whom Dr. Lillehei developed the simplified heart-lung machine based on bubble oxygenation. Twenty-three of the 154 surgeons that Dr. Lillehei trained became program directors of cardiothoracic programs and, in turn, trained 477 additional surgeons. As of 1988, a total of at least 820 cardiothoracic surgeons residing in 36 countries could trace their preceptoral lineage back to Dr. Lillehei. Very likely several hundred more surgeons around the world can now, 11 years later, trace their training lineage back to Dr. Lillehei.

Dr. Lillehei's many achievements have been recognized with numerous international awards and honors. Foremost among these honors was the Lasker Award in 1955 for "Outstanding Contributions to Cardiac Surgery." Dr. Lillehei shared this award with Drs. Richard Varco, Morley Cohen, and Herbert Warden. Other outstanding achievements (among 90 major awards) include the Harvey Prize in Science and Technology awarded by Technion in Israel in 1996 and the Hektoen Gold Medal of the American Medical Association in 1957 for his contributions to "Direct Vision Intracardiac Surgery." Dr. Lillehei was also the only living surgeon to be recognized by a festschrift issue of the Journal of Thoracic and Cardiovascular Surgery. This special festschrift issue published in November 1989 contained scientific papers presented on the occasion of his 70th birthday in October 1988. Also at that time, his former students and associates established the C. Walton and Richard C. Lillehei Professorship in Cardiovascular Surgery at the University of Minnesota.

Dr. Lillehei was a member of 45 scientific societies and was president of the American College of Cardiology. He also held an honorary membership in 33 foreign societies and honorary doctorates in five international universities. Dr. Lillehei had been nominated for the Nobel Prize in Medicine on several occasions.

Dr. Lillehei was born in Minneapolis on October 23, 1918, attended West High School in Minneapolis, and graduated from the University of Minnesota in 1939 with distinction. He graduated from the University of Minnesota Medical School in 1942 and received his Ph.D. in Surgery from the University of Minnesota Graduate School in 1951. He served in the U.S. Army between June 1942 and February 1946, entering the service as a 1st lieutenant and departing as a lieutenant colonel. He served in the African and Italian theaters and received the Bronze Star for "Meritorious Services in Support of Combat Operations" in Anzio, Italy. Dr. Lillehei completed his surgical training under Dr. Owen H. Wangensteen at the University of Minnesota and became a clinical instructor in the Department of Surgery at the University of Minnesota Medical School in July 1951. He became a professor in the Department of Surgery, University of Minnesota Medical School in June 1956 and then, in November 1967, was appointed as the Lewis Atterbury Stimson Professor of Surgery and Chairman, Department of Surgery, The New York Hospital - Cornell Medical Center, a position he held until 1974. He returned to Minnesota and was appointed as clinical Professor in the Department of Surgery, University of Minnesota Hospital in 1986. In 1970, he was appointed as Director of Medical Affairs for St. Jude Medical, Incorporated, a position he held until his death.

Dr. Lillehei was honored last October with an 80th Birthday Festschrift in Minneapolis. At that time, many of Dr. Lillehei's trainees, colleagues, friends, along with family gathered to pay tribute to the man who had impacted their lives to such a great extent. The scientific papers presented at the Lillehei 80th will be published later this year in a special issue of The Annals of Thoracic Surgery.

Dr. Lillehei is survived by his wife of 52 years, Kaye Lindberg Lillehei; a daughter, Kimberle Loken of Duluth, Minnesota; two sons, Dr. Craig Walton Lillehei, Assistant Professor of Pediatric Surgery at Boston Children's Hospital, and Dr. Kevin Owen Lillehei, Associate Professor of Neurosurgery at the University of Colorado; and a brother, Dr. James P. Lillehei, retired internist of Mendota Heights, Minnesota. A memorial service is scheduled for Dr. Lillehei in the Twin Cities on August 5, 1999, time and place to be decided.

Dr. Lillehei was truly a "surgical giant" of the 20th century - he will be greatly missed by his family, friends, colleagues and trainees. Thousands of cardiac surgeons the world over are indebted to Dr. Lillehei for his monumental contributions; also the millions of patients around the world with implantable pacemakers and artificial valves can thank Dr. Lillehei for these same contributions. Denton Cooley said it best when he stated in his discussion of Dr. Lillehei's Chamberlain Award paper at the 1985 S.T.S. meeting - "Walt, you provided the can-opener for the biggest picnic cardiac surgeons have ever known."

Muslim Medics Tend to Hindu’ Pilgrims Agony at Kumbh: Unity and Brotherhood at its Best

Haridwar, April 18, 2010: The Kumbh Mela with its swirling crowds can be as physically daunting as it is spiritually fulfilling. But soothing the aches and pains of pilgrims, mostly Hindus, has been a group of Muslims medics who have organised medical camps here, attending to as many 1000 pilgrims per day.

Hindu devotees arrive at the river Ganges to take a bath during the Kumbh Mela festival in Haridwar. The Kumbh Mela, world's largest religious festival, which is held every three years and rotates among four Indian cities, attracts huge crowds of devotees who believe a dip in the river cleanses them of sin and frees them from the cycle of life and rebirth. AFP

Azim Mir Khan is among the many doctors who has tended to devotees. "We attended to around 2,000 people in two days," said Khan, who was part of a camp set by the Sir Syed Forum, an alumni group of the Aligarh Muslim University (AMU) that believes in fostering unity and brotherhood among communities.

He said people came with problems like vomiting, stomach ailments, body aches, joint pains, dehydration and hypertension. "We kept a good stock of emergency medicines and those relating to fungal infections. We also sourced some medicines locally," Khan told IANS.

Hindu Sadhus cover their bodies with mud after a bath at the river Ganges during the Kumbh Mela festival in Haridwar. AFP

The camp set up at the Sati Kund temple in Kankhal near here coincided with Baisakhi and Mesh Sakranti - two of the most auspicious days for taking a bath in the Ganga during the Kumbh Mela.

As pilgrims had to walk long distances to reach the bathing ghats April 14-15, the doctors at the camp had their hands full. The forum organised two similar camps on the national highway leading to Haridwar.

Followers of a Hindu Sadhu pour water over his head as they bathe in the river Ganges during the Kumbh Mela festival in Haridwar. AFP

While one was held April 12-13 at Purkazi, 53 km from Haridwar, another was held March 15-16 (coinciding with the second royal bath) at Bhumanand Teerth Charitable Hospital, about seven kilometres from the holy city.

"The forum's decision to take this small step of holding medical camps is in keeping with the views and teachings of Sir Syed Ahmed Khan and his followers, who believed in joint participation in all social and religious functions to foster unity and harmony," said Syed Hussain Waheed, convenor of the forum.

Hindu Sadhus, or holy men, take a bath on the river Ganges during the Kumbh Mela festival in Haridwar. AFP

"We believe that it is the common people who pay the price of social and religious tensions and it is they who must take the initiative to strengthen national unity," he said.

The devotees were all praise for the effort by the AMU alumni, saying the initiative would foster a sense of unity and brotherhood among the two communities.

Rajesh Singh, a resident of Jhijora near Jhansi, said he felt relieved after getting medicines for the pain in his hands and legs.

Jai Prakash Gupta from Kolkata who got some medicine for the blisters on his feet, said such camps were the need of the hour. "They increase love and respect between communities and foster the feeling of brotherhood," Gupta said.

Swami Mahamandelshawar Harish Chandra Maharaj, a Hindu saint who was invited by the forum to the Sati Kund temple camp to distribute juice cans among devotees, also lauded the effort.

"Such camps create a feeling of unity," he said and added that serving people does not need any religious sanction.

Kumbh Mela is one of the biggest religious gatherings on the banks of the Ganga river, with the number of pilgrims this year expected to total around four million since the first day Jan 14 till the time it concludes April 28. The auspicious days of the shahi snan or royal baths usually draw hundreds of thousands of devotees.

Source: IANS