Cardiac Surgery

Cardiac Surgery
Medical School

Michigan Publishing
Copyright © 2015 by the Regents of the University of Michigan

The University of Michigan: An Encyclopedic Survey was first published beginning in 1942. For
its 2017 Bicentennial, the University undertook the most significant updating of the
Encyclopedia since the original, focusing on academic units. Entries from all versions are
compiled in the Bicentennial digital and print-on-demand edition.
 Contents

1. Cardiac Surgery (2016) 1

[1]

Cardiac Surgery (2016)

In 1922, Hugh Cabot, dean of the University of Michigan

Medical School and chair of the Department of Surgery,
recruited John Alexander, a Philadelphia-born surgeon trained
at the University of Pennsylvania, to join the faculty. Soon after
the appointment, Alexander was diagnosed with tuberculosis of
the pleura, spine and kidneys and underwent treatment at the
Trudeau Sanatorium in Saranac Lake, New York. When he
returned to work at Michigan in 1926, he limited his practice to
thoracic surgery, and in 1928 he established the first formal
thoracic surgery residency in the U.S. In 1931, Cameron Haight,
who trained in thoracic surgery under Alexander, joined the
Department of Surgery — then led by Frederick Coller — as its
second thoracic surgeon.
Moving into the new, Albert Kahn-designed University
Hospital in 1925, the thoracic surgeons devoted much of their
energy to the treatment of pulmonary tuberculosis. Alexander’s
interest and focus on this disease led to the publication of two
books — The Operative Therapy of Pulmonary Tuberculosis,
published in 1925 and written while he was a patient in the
Trudeau Sanatorium, and The Collapse Therapy of Pulmonary
Tuberculosis, published in 1937.
As thoracic surgery matured as a specialty, stimulated by
caring for the wounded in World War II and the evolution
of effective drug therapy for tuberculosis, Michigan’s Thoracic
2 Cardiac Surgery

Surgery Section continued to be an important center for the

treatment of thoracic surgery pathology. In 1933, Cameron
Haight performed the first total removal of the left lung for
bronchiectasis in two stages and, along with Harry Towsley,
advanced the operative treatment of congenital atresia of the
esophagus for babies with tracheoesophageal fistulae.
As the section continued to grow following World War II,
Herbert Sloan completed his residency under Alexander and
Haight in 1949 and remained on the faculty, helping with the
goal of developing the new field of cardiac surgery in adults and
children.
In 1954, Haight assumed the role of section head and oversaw
the development of cardiac surgery with Sloan and Joe D.
Morris. Their collaboration with Richard N. and Norma Sarns
led to devices for this new arena of cardiac surgery, and the
Sarns Corporation was soon formed. Many of the
cardiopulmonary perfusion machines in use around the world
in the 21st century are the products of the Sarns Corporation, a
pioneer in the biomedical industry.
With the initial cardiac procedure performed on
cardiopulmonary bypass in 1956, Herbert Sloan closed an atrial
septal defect and “open heart surgery” was established at
Michigan. In 1960, he published a report of his experience with
360 patients undergoing open heart procedures in the Journal
of the Michigan State Medical Society. The mortality following
correction of uncomplicated congenital cardiac defects was an
astounding 1.4 percent.
As the specialty of thoracic surgery continued to progress,
U-M played a major role in the evolution of the Society of
Thoracic Surgeons and its journal, The Annals of Thoracic Surgery.
The catalyst for the Society was J. Maxwell Chamberlain, a
resident under Alexander and Haight from 1938 to 1940. The
first president of the Society was Paul “Buck” Samson, also a
resident at Michigan from 1934 to 1936. John Steele, the first
editor of The Annals, was trained at U-M from 1934 to 1936 as
well. Nearly half of the steering committee for this new Society
were trained by Alexander and Haight.
Following Haight’s death, Sloan became the section head in
1970. He established three divisions within the section: General
 Cardiac Surgery (2016) 3

Thoracic Surgery, Pediatric Cardiac Surgery, and Adult Cardiac

Surgery. With Sloan’s focus, ability and leadership, he recruited
talents needed for success of these divisions, including Mark
Orringer and Marvin Kirsh.
A uniquely talented leader and administrator, Sloan was
president of both the American Association for Thoracic
Surgery and the Society of Thoracic Surgeons; secretary of the
American Board of Thoracic Surgery; and editor of The Annals
of Thoracic Surgery. He maintained the commitment to resident
education and excellence in clinical outcomes established
during the Alexander/Haight years.
With Sloan’s retirement in 1985, Orringer became head of
the section. His years —1985-1998 — were marked by further
recruitment and specialization and the advancement of thoracic
organ transplantation.
The Adult and Pediatric Cardiovascular Services continued
to evolve, expanding the horizons of neonatal pediatric cardiac
procedures, aortic and valve surgery, cardiac support devices
and heart transplantation.
In 1998, Thoracic Surgery was divided into two sections —
Thoracic Surgery and Cardiac Surgery. Orringer continued to
lead the General Thoracic Surgical Section while Edward L.
Bove shepherded the further evolution of Cardiac Surgery as its
first head.
The clinical arenas of pediatric cardiovascular surgery and
adult cardiac surgery continued to expand, with a doubling of
the faculty over the first ten years of Bove’s leadership. Surgical
volumes at the Cardiovascular Center and the C. S. Mott
Children’s Hospital increased to nearly 2,500 cardiac cases
annually.
The pediatric cardiovascular faculty expanded to four
dedicated congenital surgeons at the Children’s Hospital, while
eight surgeons worked on the adult side at the Cardiovascular
Center. In addition, two regional programs were established
with two dedicated faculty at each.
The Congenital Cardiovascular Program continued to evolve
into one of the busiest in the U.S. with a focus on neonatal
and complex procedures. The Congenital Heart Center at Mott
Hospital was established with colleagues from Pediatric
4 Cardiac Surgery

Cardiology. On the adult side, valvular heart disease, complex

aortic disease, transplant, and circulatory support became
major areas of expertise.
As cardiac surgery, cardiovascular medicine and pediatric
cardiology became increasingly integrated, the natural
evolution of Cardiac Surgery into a separate department in the
Medical School occurred in 2012, with Bove appointed as the
first chair.
The Department comprised three Sections: Adult Cardiac
Surgery, led by Richard L. Prager;, Pediatric Cardiovascular
Surgery, led by Richard G. Ohye; and Section of Health Services
Research and Quality. This last section — headed by Donald S.
Likosky, who was recruited from Dartmouth University and the
Northern New England Cardiovascular Consortium — created
a platform on which the Department could expand into the
evaluation and measurement of local, regional and national
outcomes. These analyses will play an important role in the
areas of health policy and resource utilization. Furthermore,
the maturing of this sub-specialty has facilitated the expansion
of basic science research within the Department, with a focus
on stem cells and myocardial regeneration, myocardial proteins
and cellular mechanisms.
The Department’s focus on education remains paramount,
and the traditional two-year residency in cardiac and thoracic
surgery at Michigan continues to be a highly sought-after
position. Cardiac and Thoracic Surgery established an
integrated six-year program for cardiac and thoracic surgical
residents who will enter the program immediately after
graduating from medical school. The Pediatric Cardiovascular
Section has an ABTS-approved one-year residency in Pediatric
Cardiovascular Surgery that is offered following completion of
a standard residency in Cardiothoracic Surgery.
With its rich heritage, tradition and commitment to
excellence in clinical care, education, research, and policy, the
Department of Cardiac Surgery at the University of Michigan
remains a leader in all areas of cardiac surgery.