Julian's reintroduction of Milton's operation

Four years after the first successful open heart operation in 1953, most cardiac surgeons were using bilateral anterior thoracotomy. This tedious, time-consuming, complication-prone, painful procedure was abandoned only after Julian and associates demonstrated the marked superiority of median sternotomy. Although median sternotomy was described by Milton in 1897, it was a seldom-used procedure at the time of Julian and associates' publication in 1957. The present-day routine use of median sternotomy for virtually all cardiac operations is a testimonial to the foresight and practicality of Julian's experience.