The Gross-Taussig Shunt

There was once a heart surgeon who was the acknowledged expert in Pediatric Heart Surgery. Dr. Helen Taussig once approached him asking for advice about re-routing some blood vessels to relieve a Congenital Malformation of the Heart known as Tetralogy of Fallot (ToF).

This surgeon was not Dr. Alfred Blalock.

As I mentioned yesterday, everyone is born with two heart defects: The foramen ovale and the  ductus arteriosus, which is a direct connection between the Pulmonary Artery and the Aortic Arch. It allows blood coming from the Right Ventricle to bypass the lungs, and it closes shortly after birth. If it fails to close it is refered to as a “patent ductus arteriosus” (PDA), and can lead to Congestive Heart Failure.

Robert Gross was born in 1905 and by 1938 was the Chief Resident at Children’s Hospital in Boston.  Children’s Hospital had been experimenting with closing PDAs in animals and was having success, and Gross was eager to try the repair in a human. Being a good Resident, he asked his boss, highly respected Surgeon-in-Chief  Dr. William E. Ladd. Ladd said no – we do not touch the heart.

Not long after that, Dr. Ladd went on vacation. Dr. Gross went to his substitute, Dr. Thomas Lanman, and again asked permission. Lanman gave him the OK, and on August 26, 1938, Dr. Gross closed the PDA of  a little girl named Lorraine Sweeney. Everything went perfectly.

Dr. Ladd came back from vacation, learned what had happened, and fired Dr. Gross.

Gross wasn’t out of work for long – the higher-ups at Boston Children’s thought the surgery was a great thing, and sent Dr. Ladd to rehire Dr. Gross! Rather than holding a grudge against Gross, Ladd came to realize just how good he was and the two teamed up. Working together, the two devised several new heart operations over the years and experimented with valve replacements and a heart lung machine. When Dr. Ladd retired, Dr. Gross was selected to replace him.

In the early 1940’s a young female doctor from Baltimore visited Dr. Gross. Since he was one of the leading Cardiac Surgeons of the time, she discussed with him a theory that she had: Although it was impossible (at the time) to do surgery on the heart, she felt that Tetarology of Fallot (ToF) could be relieved by redirecting some of the major blood vessels.

Gross was intrigued by the idea. When this doctor offered him the chance to actually help develop such an operation, Gross hesitated. She seem to be smart enough, and she did work at Johns Hopkins. They were as prestigious as Boston, and wouldn’t just hire anyone. But there were so few female doctors around no one would take her seriously…. and he turned her down.

So Helen Taussig, M.D., got back on the train and returned to Baltimore. A few years later Alfred Blalock was named Chief of Surgery at Johns Hopkins. Had Gross accepted Taussig’s offer, the first Congenital Heart Surgery could have been named the Gross-Taussig Shunt.

If it had worked. Without Vivian Thomas – who came to Hopkins with Dr. Balock – the operation could have failed and wrecked both of their careers.

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