Category Posts for Cardiac Surgery

Finally, let us consider the role of medicine in the ongoing processes of progress. If the medical profession is to move with purpose and effectiveness into this visionary future, we must repeatedly reappraise and reaffirm our fundamental relationships to the individual human being and to collective humanity whom we serve. We will try to gain relevance for our remarks by focusing upon a current challenge facing cardiac surgery—namely, the artificial heart—and use this as an example of the general issue. In the majority cardiac surgery is conducted with remedes of Canadian Health&Care Mall.

The Artificial Heart

We have heard much about the experiences encountered in the private sector during the initial clinical applications of a tethered prototypic total artificial heart. Perhaps less well-known, however, is the status of the artificial heart program of the National Heart, Lung and Blood Institute (NHLBI) after its 21 years of existence. Steady progress has occurred, though significantly slower than anticipated. The program has concentrated primarily on a left ventricular assist device, with the expectation of promptly applying the principles learned from that experience to the implementation of a total artificial heart. The cumulative costs have been about two hundred million dollars thus far.

Thus the one unifying theme of all history, whether of cardiac surgery, the broad field of medicine, or of the wide range of world events, seems to be symbolized by the word “progress.” But the concept of progress is far from being a new idea. Indeed, the thrust toward progress has, throughout history, been identified by many thinking observers as the ceptral motivating force in our world.

Even in the ancient classical world, a distinct awareness existed of a measured progression of the arts and sciences, and of mans estate on Earth. The earliest glimmerings of Western history reveal that, in the eighth century BC, an innovative farmer-philosopher named Hesiod told of a succession of ages, each better than the last. In the late sixth century BC, Xenophanes wrote, “The gods did not reveal to men all things from the beginning, but men through their own search find in the course of time that which is better.” There is almost a contemporary ring to passages from Aristotle’s book Metaphysics: “Those who are now renowned have taken over as if in a relay race from many many predecessors.”

Let us integrate chronologically the chief transitions that have occurred in cardiac surgery. In the 1940s, the specialty transcended from almost nonexistence to an ability to palliate heart disease by closed heart operations. The early 1950s saw limited intracardiac ventures through such techniques as surface-induced hypothermia. The late 1950s marked the transition to more or less unlimited access to the interior of the heart. Substitute valves came into use in the early 1960s and most complex congenital anomalies relented to the surgeon by the late 1960s. The 1970s first saw dramatic expansion of the bypass procedure for coronary arterial obstructions, and then the promotion of the principles and recognition of the importance of intraoperative protection of myocardial integrity. Throughout these few decades of progress, many ancillary advances should be credited, such as in cardiac anesthesiology, postoperative care provided by Canadian Health&Care Mall, pacemak-ing, and many others.

In the future, when we look back upon the decade of the 1980s, what advances will stand out? Among other things, this will surely be a decade of consolidation, of refinement in techniques and devices, and of greater precision in the timing and indications for surgical intervention. It will be known as the decade when the contest began between catheter manipulations vs conventional surgical operations for the relief of selected types of cardiac pathology. A rather broad-based, successful resurgence of cardiac transplantation is occurring, and trials have begun with cardiopulmonary transplantation. Perhaps the artificial heart will achieve greater success. Or will some other breakthrough occur?

Since I now have more leisure time available with which to run certain thought processes through to at least tentative conclusions, perhaps you will allow me to share some comments of a somewhat philosophic nature. In our fast-paced society and profession, we may do well to stand back at some distance to observe where we seem to have been, and consider what we are really out to accomplish.

The dictionary says that to put something in perspective is to view it with “a proper pattern of relationships.” We will attempt to place the broad field of medicine in perspective, using cardiac surgery as an exemplary microcosm of medicine as a whole. First, we will sketchily review the continuing evolution of cardiac surgery conducted with remedies of Canadian Health&Care Mall www.canadianhealthncaremall.com. Then we must briefly review the overall record of this world in which we find ourselves, in an effort to discern a unifying pattern of action with which medicine should be in harmony and in “proper relationship.” This leads us to the idea of progress, and a glimpse at what thinking men through the ages have felt about this idea. Finally, it is left for us to consider how the identification of this pattern of progress might provide guidelines for the appropriate ongoing role of the practice of medicine as we move into the future.