The Holmes heart: historic associations and pathologic anatomy

In 1824, Andrew F. Holmes, later to become the first Dean of the Medical Faculty of McGill University, published the autopsy findings of a 21-year-old man who had died with chronic cyanosis and congestive heart failure. Autopsy revealed the first documented case of single ventricle. Reinspection and detailed photographs published for the first time show absence of the sinus (body or inflow tract) of the morphologically right ventricle (RV) and hence a single (unpaired) morphologically left ventricle (LV), double-inlet LV, infundibular outlet chamber (IOC), and normally related great arteries, with the pulmonary artery arising from the IOC and the aorta from the single LV. In view of its rarity, William Osler urged Maude Abbott to republish this case, which she did in 1901. Republication of the Holmes heart catalyzed the career of Maude Abbott, who then proceeded to become the world's authority on congenital heart disease until her death in 1940.