Gibbon's heart-lung machine

John Gibbon and the heart-lung machine: a personal encounter and his import for cardiovascular surgery

This chapter describes the historical evolution and implementation of different mechanical blood pumps for the use in heart–lung machines. It starts with the use of blood-filled rubber bulbs that were intermittently squeezed from the outside in order to mimic the pulsatile blood flow that the natural heart generates, and ends with the development of very powerful, high-tech centrifugal blood pumps with extremely low hemolysis rates. It covers Drs. John Gibbon’s and Michael E. DeBakey’s contribution to the field and describes technical details, advantages and disadvantages of several different pump-types used in the past and present in heart–lung machines.

A succinct, historical review of developments in mechanical devices to assist the failing heart is provided.

A number of methods of mechanical devices to assist the failing heart are briefly assessed. Personal experimental and clinical studies of devices developed over several decades are presented.

Findings and data of devices used in assisting the failing heart, including those developed by the author, are analyzed.

On the basis of this review, the left ventricular assist device is believed to be the most effective. There is also reason to believe that the axial flow system has considerable advantages. This form of therapy has potentially great value for permanent use in some patients with intractable heart failure.

Cardiothoracic surgeons are uniquely and expertly positioned to be innovators. Innovation is an iterative process by which unmet needs are identified, a solution is invented, and the results are implemented. A team approach is required, with participation from a variety of experts including the surgeon-innovator. Innovation can be practiced on a multitude of pathways including basic science, clinical science, and commercialization. Economics realities are often the ultimate determinant in the success or failure of any innovative effort. In this manuscript, we aim to define innovation, describe the innovative process, and demonstrate how these principles can, and should, be enacted by cardiothoracic surgeon-innovators.