CHRISTIAAN BARNARD BIOGRAPHY PDF
Professor Chris Barnard led the team which performed the first human-to-human heart The son of a missionary, he was born into very modest. Dr. Christiaan Barnard was a South African cardiac surgeon who performed Check out this biography to know about his childhood, family life. in a separate window · Figure 1. Christiaan Barnard not long after he performed the first heart transplant. He was born on November 8th, Although not.
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The daring operation and the charismatic surgeon received immense public attention around the world.
Christiaan Barnard – Wikipedia
Although the patient, Mr. Louis Washansky, died after only 18 days, Barnard soon carried out a second transplant, and this patient led an active life for almost 19 months. Barnard subsequently introduced the operation of heterotopic heart transplantation in which the donor heart acted as an auxiliary pump, with some advantages in that early era.
It took great courage to carry out the first heart transplant, and this is why Barnard is remembered as a pioneer in cardiac surgery. Christiaan Barnard was the third son of four of a church minister in the rural town of Beaufort West in South Africa, approximately miles inland from Cape Town.
He was born on November 8th, 1,2. Back row, left to right: Chris is second from left. After attending the local high school, Chris Barnard did well enough to gain entry to study medicine at the University of Cape Town UCTwhere he was financially dependent on two scholarships he had been awarded. If he failed an examination, he would lose the scholarships and would no longer be able to pursue his goal of becoming a doctor.
Christiaan Barnard—The surgeon who dared: The story of the first human-to-human heart transplant
He enjoyed this work but, when problems arose between him and his two colleagues, he resigned his position and returned to the Cape Town area to study for higher surgical examinations.
This proved a difficult period for him as he had no income, but now had two small children to support. Fortunately, a position became available at the local infectious disease hospital and this led to further appointments, first christtiaan medicine and then in surgery, at GSH, the major UCT teaching hospital Figure 3.
During this period, in the evenings and nights, he carried out some very innovative research in a canine model of intestinal atresia in neonates 3. Wildebeest graze on the land behind the hospital. In the s, the small houses in front of the hospital were demolished to allow construction of the present hospital. Fortunately, barnxrd beautiful original buildings have been retained, and continue to be used chrisstiaan many purposes.
He was then offered a scholarship to gain surgical experience at the University of Minnesota in Minneapolis under the tutorship of the legendary Professor Owen Wangensteen. It was there that he was first biogrraphy to the very new field of open heart surgery, the University Hospital in Minneapolis being only one of a handful of centers in the world where this form of surgery was being carried out.
Barnard immediately saw the potential of the heart-lung machine pump-oxygenator and, under the direction of C. He immediately initiated an open heart surgery program at GSH Figure 5which was associated with excellent results and gained him a good reputation from those who followed his progress 4—6.
He also designed and implanted a prosthetic valve that was successful for that era Figure 6 10— In the relatively early s, by which time heart surgery could correct most congential heart defects and treat valve disease but not yet coronary artery diseasehe began to consider the future of his specialty.
He concluded that heart transplantation would be required if patients with end-stage heart failure were to be helped. At the time, I thought perhaps he was joking but, in retrospect, he clearly was not. With a view to moving towards heart transplantation in patients who might benefit from it, Barnard and his younger brother, Marius Figure 7who barbard also a cardiac surgeon at GSH, began by gaining experience of the operation of orthotopic heart transplantation in dogs He used an operative technique first described by Russell Brock and a junior colleague in London in 16but developed and investigated extensively by Norman Shumway and his research team at Stanford University in the USA 17 Figure 8.
Barnard made little attempt to keep the dogs alive as his main aim was to perfect the surgical technique. He then took a three-month sabbatical to gain experience in immunosuppressive therapy in patients with kidney transplants, which he did by attaching himself to the transplant program headed by David Hume Figure 9 in Richmond, Virginia.
There he also gained more experience of experimental heart transplantation in the laboratory of Richard Lower Figure 8who had trained with Shumway, but had subsequently been recruited to Richmond by Hume. With this experience behind him, Barnard returned to GSH and carried out a single successful kidney transplant on a patient who lived for 20 years.
Barnard then felt ready to carry out a first heart transplant. They therefore agreed that both recipient and donor should be Caucasian white.
Schrire identified Louis Waskansky Figure 10a year-old diabetic, who was bedridden in hospital in severe cardiac failure from ischemic heart chtistiaan Washkansky readily accepted the opportunity as he knew he had no alternative if he wanted to stay alive. The surgical team then waited for a suitable donor. In the afternoon of Saturday, December 2nd,Denise Darvall Figure 11a year-old woman, was barnaard to GSH having suffered a severe brain injury as a result of a traffic accident Within hours, she was certified brain-dead by the hospital neurosurgeons, and her father gave his consent for her heart and kidneys to be used for transplantation.
Both potential recipient and donor were taken to the operating room suite, and the operation took place during the early hours of December 3rd Therefore, Barnard concluded he could use brain death as a criterion for declaring a patient dead.
Nevertheless, to be quite sure that he would not be faced by medico-legal problems, he decided he would wait for the heart to stop beating before he removed it. He therefore disconnected the ventilator, and waited until the EKG indicated no cardiac output. This took approximately six minutes.
The chest was then opened quickly by splitting the sternum. The heart was blue and not beating. The surgical team connected the donor to a heart-lung machine, and circulated cold oxygenated blood through her body, with the aim of reducing the metabolism of the heart while it was transplanted. The heart was rapidly cooled to a low temperature, helping to protect it from further ischemic injury during transplantation. The donor heart was excised in such a way that the donor heart-lung machine would continue to perfuse it with cooled oxygenated blood while it was carried into the adjacent recipient operating room.
Thus, the heart continued to be protected from injury. This approach is rarely followed today when a beating donor heart is simply cooled to a very low temperature by perfusing it with a christaian preservation solution, then excised, and covered in ice or cold saline.
However, the continuous perfusion of the donor heart with oxygenated blood in Mr. I found it quite remarkable that the team had not practiced the operation together. Over the previous few years, Mr. It was therefore much larger than a normal healthy heart. Barnard looked at it and wondered whether it was too small to support the circulation in such a relatively big man. This observation must have been very disturbing to him, bigoraphy he could do nothing about it now.
The surgical team waited for the heart to beat, but for some minutes it refused to do so although it was fibrillating. He electrically defibrillated the heart, and at last it began to contract normally, but only weakly, and would not take over the circulation. Barnard tried twice to wean the patient from pump-oxygenator support, but the heart was not beating strongly enough to maintain an adequate blood pressure. He allowed more time for the donor heart to gain strength, continuing to keep the patient alive on the heart-lung machine.
Steadily the beats became stronger. At the third attempt to discontinue the heart-lung machinethe blood pressure kept rising. The heart-lung machine could now be switched off, and the chest closed. The operation had been successful. When he was satisfied the heart was beating well and the patient would recover, Chris left his colleagues to close Biograhpy. The hospital superintendent, Dr Jacobus Burger, was surprised to learn of the operation, but pleased that the patient was doing well.
The chairman of surgery was equally pleased, but wondered why Barnard had not been in touch with him before he biogrxphy the operation. However, he must have had some realization that the operation he had just performed was special because he also telephoned an old friend from their medical student days who was a member of the Executive Committee in charge of Hospital and Health Affairs in the Cape Provincial Administration, a political position of christiiaan influence This politician immediately recognized the significance of the transplant, and informed the Administrator of the Cape Province similar to a State Governor in the USA who, in turn, telephoned the Prime Minister of South Africa.
The importance of this unique operation to South Africa is evident by the fact that, within about 30 minutes of Barnard christoaan the operating room, the Prime Minister of the country had been informed. The politicians had immediately realized its potential impact on the barnnard. It could put South Africa on the medical map.
How wrong could he be? Washkansky on the operating table, but, of course, no photographs had been taken. When he had seen Mr. Washkansky settled safely in his intensive care room, Barnard drove home.
It was only an hour later when phone calls came from all over the world. Chris told me many times that he and his colleagues were stunned by the interest the transplant engendered. So great was the public interest that the entire team was called back into the hospital that afternoon to be photographed Figure Journalists and photographers flew in from all over the world and swarmed over Groote Schuur Hospital.
Radio and television services worldwide provided bbarnard and updates on Mr. On the front page of several local newspapers, a photo showed Louis Washkansky, and was transmitted around the world within twenty-four hours Figure After the first week, Mr.
Christiaan Barnard ()
Washkansky began to feel tired and less well. In retrospect, it is clear that his recovery was impaired by allowing him to have too many visitors and give too many interviews to the media.
After approximately 12 days, his condition began to deteriorate, and he developed radiographic infiltrates in the lungs. Despite intensive antibiotic treatment, Mr. Washkansky deteriorated bwrnard and died in the early hours of Thursday, December 21st, 18 days after the transplant.
Exhausted by his efforts to keep his patient alive, Barnard was devastated by this sad outcome. An autopsy was carried out immediately by the professor of pathology, James Thompson He could find no features chrisiaan rejection of the heart, and confirmed that death had resulted from pneumonia.
By inspecting the suture lines, he ascertained that Barnard had performed the operation faultlessly. Barnard bounced back from his disappointment over the outcome of Mr. The patient was a retired dental surgeon, Philip Blaiberg Figure 15who was in a similar clinical state of terminal cardiac failure as Mr.
A donor became available on January 2nd,and the operation proceeded satisfactorily. Dr Blaiburg was discharged from GSH on the 74th post-operative day, and lived a fairly full and active life for almost 19 months 23eventually dying from the hitherto unknown condition of graft atherosclerosis chronic rejection Remarkably, his fifth patient lived for almost 13 years, and his sixth for more than 23 years 25— Unfortunately, the immense media attention directed towards the attractive and articulate Barnard steadily distracted him from his work, as he was seemingly always willing to accept any invitation to speak anywhere in the world.