A Tribute to the Pioneers of Right Heart Bypass: An Historical Review

Abstract

Cavopulmonary anastomosis was first described by Carlon, Mondini, De Marchi in a canine model in 1951 and later, in the clinical practice, by Glenn in 1958. Total right heart bypass was first introduced by Fontan and Kreutzer in 1971, in each instance as treatment for tricuspid atresia. Several modifications of such a procedure followed the initial concept of the right atrium as a pumping chamber, including modifications aimed to minimize energy loss at the anastomotic level and arrhythmias. Tribute is given to our pioneers who developed such an operation aimed to treat any child with functionally univentricular hearts.

Vincenzo Gallucci: Memories of a Surgeon, Scientist, and Teacher

“…It was in the early 1950s that Carlo A. Carlon, a young surgeon in Padua and a pioneer of cardiac surgery in Italy, was the first to demonstrate experimentally the feasibility and effectiveness of the cavopulmonary anastomosis, giving a fundamental contribution to the rising treatment of cardiac malformations characterized by pulmonary hypoperfusion. 20,21 In the late 1960s, Vincenzo Gallucci returning from his American experience was strongly influenced by his work during such intense and productive years. When he first met Aldo Castaneda, who was developing a prestigious pediatric cardiac surgery program at the Boston Children's Hospital, he immediately understood that correction of many congenital heart defects in the neonatal period and early infancy, by avoiding palliations, had the potential for becoming soon the treatment of choice of most, even complex heart malformations.…”

Extremely Long-Term Follow-Up of Dr William Glenn's Original Patient Cohort With Superior Cavopulmonary Anastomosis (1958-1990)

“…Independently from Carlon and colleagues, cavopulmonary anastomosis experiments were also performed by many surgeons including Francis Robicsek, Jose Patino, Tiger Carbidion, Nicolai Galankin, and William Glenn in the 1950s. 1,2 Worldwide, surgeons during the mid-1950s to early-1960s proceeded to clinical application in patients including Schumaker, Meshalkin, Glenn, Rasmussen, Robicsek, and Santy. 1 Carlon's first clinical experience would later be reported in 1964.…”

“…The application of creating a superior cavopulmonary anastomosis as a second-stage palliation in patients with functional single ventricle would not be adopted until a few decades later. 2,8 For babies born with hypoplastic left heart syndrome, palliative stage I Norwood operations were just being developed. 9 As the next step in bypassing the right heart to allow passive blood flow to the pulmonary arteries, with the discovery of the total cavopulmonary connection, there was unfortunately an observed high mortality in infants undergoing both SVC and inferior vena cava routing of blood flow to the pulmonary arteries in the late 1970s.…”

Surveillance of Fontan-associated liver disease: current standards and a proposal from the European Society of Paediatric Radiology Abdominal Task Force

“…The Fontan procedure was initially performed in 1968 for children affected by tricuspid atresia [ 1 ]. Since then, the surgical technique has been modified [ 2 ] and currently consists of a series of planned surgical interventions that occur from shortly after birth until 2–4 years of age, resulting in a direct connection between the caval veins and the pulmonary arteries (Fig. 1 ).…”