[Historical data and some comments on closed techniques in cardiac surgery]

On the 29th of May, 1907 Ortiz de la Torre preformed, in the General Hospital of Madrid, the first surgery to treat a cardiac wound. In this same year Rehn reported the first 124 cases of sutured cardiac wounds, following the first one, performed by him, in the world on the 9th of September, 1896 which opened the cardiac surgery. This started with the so called closed techniques. We are presenting some data according to our own experience in honor to those pioneers surgeons. The most important contributions are reviewed as follows: 1. The suture of the heart's wounds with the definitive aportation of Rehn on the 9th of September, 1896. 2. The extracardiac surgery related with: a) Pathology of the pericardium with the proposals of Weill in 1895 and Delorme in 1898, about removing it in case of constrictive pericarditis and the first decortication executed by Rehn in 1920. The first case of removing a pericardium's cyst by Pickhardt in 1934, is mentioned. b) The great vessels' pathology with the contribution of Trendelenburg (1908) in case of lung embolie and the first patient operated with success by Kirschner in 1924. The ligature of the patent ductus arteriosus done by Gross and Hubbard in 1939, with the previous findings of Munro and Strieder. The resection of the narrow segment in coarctation of the aorta done by Crafoord, under sugerence of Nylin, in 1944. c) Extracardiac surgery in order to correct intracardiac pathology with reference to the several types of systemic-pulmonary anastomosis, starting with Blalock-Taussig operation in Fallot's tetralogy done the first time November 29th of 1944, and after that the Pott's aorto-pulmonary anastomosis (1946), the superior vena cava-right pulmonary artery anastomosis or Glenn's operation (1954), the Waterston's ascending aorta-right pulmonary artery anastomosis (1962) with the Cooley's modification (1965). It is also mentioned the banding of the pulmonary artery after Miller and Dammann (1952) as well as the techniqes aiming to correct the pulmonary hypertension in mitral stenosis. Lastly he quotes venous transposition operations in the treatment of transposition of the great vessels (Lillehei, Greech, Baffes). 3. With regard to the group of closed techniques which aim is to correct intracardiac pathology, the following techniques are taken into account: Blalock-Hanlon's operation (1948) that create an interauricular communication in case of transposition of great arteries and Rahskind's technique. Within mitral stenosis, sugerence of sir Lauden Brunton (1902), efforts of Cutler, Levine and Beck and the pioneer Souttar's surgical procedure, in 1925, are described. Afterwards Bailey's intervention (10th Juny 1948) and Harken and other surgeons are mentioned. Figuera's instrument, introduced through left auricle is also described. The first efforts to correct aortic and pulmonary stenosis are described from the initial contributions of Tuffier, Doyen (1913), Brock and Sellors (1948) ending with the ingenious attempts of closing interauricular communication with Swan's and Hufnagel's buttons (1950), Bailey's atrioseptopexy, Sondergaard's technique and Gross'well technique. Finally the pioneer Bailey's aportation (February 6th 1951) for closing interventricular septal defect using a tube of pericardium introduced through the interventricular defect, going out through the wall of the left ventricle.