page_title: Cardiopulmonary bypass
section_title: History
hierarchical_section_title: Cardiopulmonary bypass / History
caption_attribution_description: English: Cardiopulmonary bypass machine used at the University of Michigan in the 1950s.
context_page_description: Cardiopulmonary bypass is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the patient's body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment.
  CPB mechanically circulates and oxygenates blood for the body while bypassing the heart and lungs. It uses a heart–lung machine to maintain perfusion to other body organs and tissues while the surgeon works in a bloodless surgical field. The surgeon places a cannula in the right atrium, vena cava, or femoral vein to withdraw blood from the body. Venous blood is removed from the body by the cannula and then filtered, cooled or warmed, and oxygenated before it is returned to the body by a mechanical pump. The cannula used to return oxygenated blood is usually inserted in the ascending aorta, but it may be inserted in the femoral artery, axillary artery, or brachiocephalic artery.
context_section_description: The Austrian-German physiologist Maximilian von Frey constructed an early prototype of a heart-lung machine in 1885 at Carl Ludwig’s Physiological Institute of the University of Leipzig.
  However, such machines were not feasible before the discovery of heparin in 1916, which prevents blood coagulation. The Soviet scientist Sergei Brukhonenko developed a heart-lung machine for total body perfusion in 1926 which was used in experiments with canines. A team of scientists at the University of Birmingham (including Eric Charles, a chemical engineer) were among the pioneers of this technology.
  Dr. Clarence Dennis led the team at the University of Minnesota Medical Center that on April 5, 1951, conducted the first human operation involving open cardiotomy with temporary mechanical takeover of both heart and lung functions. The patient did not survive due to an unexpected complex congenital heart defect. One member of the team was Dr. Russell M. Nelson, who later became president of The Church of Jesus Christ of Latter-day Saints and who performed the first open heart surgery in Utah.
  The first successful mechanical support of left ventricular function was performed on July 3, 1952, by Forest Dewey Dodrill using a machine co-developed with General Motors, the Dodrill-GMR. The machine was later used to support right ventricular function.
  The first successful open heart procedure on a human utilizing the heart lung machine was performed by John Gibbon and Frank F. Allbritten, Jr. on May 6, 1953 at Thomas Jefferson University Hospital in Philadelphia. They repaired an atrial septal defect in an 18-year-old woman. Gibbon's machine was further developed into a reliable instrument by a surgical team led by John W. Kirklin at the Mayo Clinic in Rochester, Minnesota in the mid-1950s.
  
  The oxygenator was first conceptualized in the 17th century by Robert Hooke and developed into practical extracorporeal oxygenators by French and German experimental physiologists in the 19th century. Bubble oxygenators have no intervening barrier between blood and oxygen, these are called 'direct contact' oxygenators. Membrane oxygenators introduce a gas-permeable membrane between blood and oxygen that decreases the blood trauma of direct-contact oxygenators. Much work since the 1960s focused on overcoming the gas exchange handicap of the membrane barrier, leading to the development of high-performance microporous hollow-fibre oxygenators that eventually replaced direct-contact oxygenators in cardiac theatres.
  In 1983, Ken Litzie patented a closed emergency heart bypass system which reduced circuit and component complexity. This device improved patient survival after cardiac arrest because it could be rapidly deployed in non-surgical settings.
caption: Cardiopulmonary bypass machine used at the University of Michigan in the 1960s.
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