Creation of Cardiac Anesthesiology
It is impossible to say when or who began cardiac anesthesiology, but it is possible to describe the evolution of this new medical specialty over the past seventy-five years. First, it is important to define cardiac anesthesiology: it is the anesthetic practice focused on the preoperative, intraoperative and postoperative evaluation and management of patients with cardiac and intrathoracic vascular disease. Those practicing cardiac anesthesiology generate new knowledge applicable to all, but have a primary focus on cardiovascular, pulmonary, renal and central nervous systems. Finally, cardiac anesthesiology is committed to educating those specializing in this practice and who might apply such concepts and principles more broadly in all medicine.
It is impossible to discuss cardiac anesthesiology without mentioning cardiac surgery that in most cases is responsible for the creation and evolution of cardiac anesthesiology. Anesthesia was initially provided in the early cardiac operations by skillful clinicians (both physician and nurse) as surgeons developed novel operations to palliate and cure congenital and acquired diseases of the heart. A great example of this is Merel Harmel at Johns Hopkins Hospital who gave anesthesia for the first Blalock-Taussig operation and who published the results of their first series at Johns Hopkins. Harmel never considered himself a cardiac anesthesiologist, and indeed at that time and later never concentrated in this area preferring to be a “generalist.”
It is the “specialists” in cardiac anesthesiology who are largely responsible for its growth, maturity and recognition now as a medical specialty. These people and the cardiac surgical programs at which they worked primarily in the 1970's and 1980's deserve special attention since this was the time and the places that with the proliferation of cardiac surgical programs due to the effectiveness of coronary artery bypass surgery that new people and new knowledge were required to serve the need for anesthesiology specialization in this aspect of medicine. More recently the field has been accredited for specialized training and it now is a full-fledged medical specialty. This is the story that will be told in this year's William W. L. Glenn Lecture.
- © 2010 by American Heart Association, Inc.