Here’s an article from a 2001 issue of the medical journal Circulation: Researchers studied Centers for Disease Control (CDC) records from 1979 to 1997, searching for deaths in which a Congenital Heart Defect was a factor. After identifying over 124,000 deaths that met the criteria, they discovered a few amazing facts:
* From 1979 to 1997, Congenital Heart Defect (CHD) deaths declined 39.4%.
* During the same time period, deaths associated with a CHD – in other words, a death in which the defect was a contributing factor but not the direct cause – dropped from an average of 7169 to an average of 5822. That is a decline of 5.32%.
* The number of infant deaths dropped by 50% over the study period.
So the big question is why? What are we doing right? The answer is “Nearly everything.” We’ve got better technology. Better methods of putting the patient under for surgery. For example, the “correct” formula for rendering a patient unconscious used to be X milligrams of Ether per Kilogram of body weight. Ether hasn’t been used since the 1960′s, and hardly anyone remembers the correct ratio anymore.
We’ve got a better, standardized heart-lung machine. In the early days of cardiac surgery there was no open heart surgery because no one could figure out how to operate on a beating heart. There were experiments with using another human being as a heart-lung; running cross- circulation tubes and then stopping the heart while the other person’s heart and lungs took over for them. This left the chance that two people could perish during a surgery gone wrong – but surprisingly, the first person to undergo the procedure survived. She’s still alive today, but is a very private person and only a few select people know where she lives.
There were experiments with putting the patient in a tub full of ice and stopping the heart that way. The idea was interesting, but it never really worked. And then there was the first heart-lung machines – everyone who had an idea built one, it seemed, and in the mid 1950s there were several different versions available. Most of them used tubing from the same beer company – the same type of plastic tubes that deliver the beer into your glass when the bartender pulls the handle! But that was the best tubing that could be found, so that’s what they used. But now we have an even better, standardized Heart-Lung machine. A surgeon who worked last week in Chicago can step into an operating room in Sacramento and feel comfortable with his equipment.
The level of care has improved. Post surgical procedure used to involve sending the patient to “Cardiac Care” which was really just a spiffy ward. Only over time did the highly specialized Heart Units develop, along with the skills of the people who work there. Take the best nurse at Johns Hopkins in the 1940′s – better yet, take Helen Taussig herself – and drop her into a 2009 Cardiac Intensive Care Unit. She wouldn’t have the skills needed to work there.
And it is improving even more, all the time.