Clarence Walton Lillehei

1918-1999

American Surgeon

Clarence Walton Lillehei was one of the leading innovators of modern cardiac surgery. Through his pioneering advances in open-heart surgery and the use of the pacemaker, countless lives have been saved. Open-heart operations that once seemed like science fiction are now commonplace in hospitals around the world.

Lillehei was born in Minneapolis on October 23, 1918. He attended a local high school, and went on to graduate with honors from the University of Minnesota in 1939. In 1942 he graduated from the University of Minnesota Medical School.

During World War II, Lillehei served from 1942-46 in the United States Army, enlisting as a first lieutenant and eventually rising to the rank of lieutenant colonel. He was awarded the Bronze Star for "meritorious services in support of combat operations" while serving in Anzio, Italy. After returning from the war, he received his Ph.D. in surgery from the University of Minnesota Graduate School and became a clinical instructor in the University of Minnesota Medical School's Department of Surgery in 1951. He taught medical students as a professor in that department in 1956, and was later appointed its chairman, a position he held for seven years.

Lillehei was known by his peers and admirers as the "father of open-heart surgery," a title he earned by developing the techniques that first made surgery on the human heart a possibility. Until the 1950s, there was no surgical replacement for the natural process by which oxygen was pushed into the bloodstream and circulated throughout the body. Opening the heart and interrupting this process without creating an alternate oxygen pathway was impossible. The only heart ailments that could be remedied, therefore, were those that could be treated without direct invasive surgery.

Two of Lillehei's predecessors in the field, John F. Lewis and John H. Gibbon, Jr. (1903-1973), had in the early 1950s successfully used artificial pump oxygenators to circulate oxygen while they repaired atrial heart defects. After their landmark operations, however, progress in heart surgery was stalled after the oxygenators failed on several occasions. Also, many surgeons at the time held the misconception that open-heart surgery was impossible without the availability of an artificial heart to support post-operative recovery.

To overcome these obstacles, Lillehei pioneered the use of "cross circulation," in which the patient being operated upon was hooked up to the bloodstream of a healthy donor by tubes. Lillehei and his team used this method for the first time at the University of Minnesota on March 26, 1954. The operation was a success, representing the first step in the development of open-heart surgery.

"Cross circulation" ultimately proved too risky to the donor and was soon abandoned, but a new method Lillehei developed proved even more effective. In 1955 he and colleague Richard A. DeWall used a heart-lung machine, called a helix reservoir bubble oxygenator, to 'bubble' oxygen throughout the bloodstream during an operation.

Lillehei made several other breakthroughs in the 1950s, which made the treatment of once-fatal heart conditions possible. One such condition is known as "heart block," in which the body is unable to produce the small electrical signals that regulate heartbeat. Heart block was one of the leading causes of death among patients undergoing repair of ventricular defects.

In 1957 Lillehei and his colleagues were able to successfully link wires into the human heart, electronically replicating the missing signals and causing the heart to beat in a steady rhythm. The signals were generated by a battery-powered pacemaker—which was about the size of a pack of cigarettes—small enough to be easily hidden under the patient's clothing. Lillehei introduced his pacemaker at a conference on cardiovascular surgery in January 1958. The pacemaker ultimately created a billion-dollar industry, allowing those with heart defects to live a healthy, normal life.

Lillehei also made advancements in the management of heart valve disease. For the first time, diseased valves could be replaced with artificial valves, like the widely used St. Jude Mechanical Heart Valve. In 1967 he introduced a new type of artificial heart device consisting of layers of plastic sheets and silicone rubber membranes that helped strengthen hearts weakened by disease.

While heading up the surgical team at New York Hospital in 1969, Lillehei performed the first heart and double-lung transplant at that hospital, placing the organs of a 50-year-old woman into a 43-year-old man suffering from terminal lung and heart failure.

Lillehei was not only himself a pioneer, he trained hundreds of doctors in the precise art of heart surgery, and wrote numerous papers and articles on the subject. His protegees included Norman Shumway, who went on to develop the surgical technique used in the heart transplant operation, and Christiaan N. Barnard (1922- ), the South African surgeon who performed the first successful heart transplant in 1967.

Lillehei's achievements have been recognized with numerous international honors. He was nominated for the Nobel Prize in Medicine several times, received the 1955 Lasker Award for "Outstanding Contributions to Cardiac Surgery," the Harvey Prize in Science and Technology, and the American Medical Association's Hektoen Gold Medal. Lillehei was President of the American College of Cardiology, and held honorary memberships in 33 foreign societies, as well as honorary doctorates at five international universities.

Lillehei succumbed to cancer in July 1999. He was 80 years old. Though he is no longer living, his great contributions to cardiac surgery continue to improve and prolong the lives of many others.

STEPHANIE WATSON