The year - 1930; the hospital - Johns Hopkins; the department - Paediatric; the doctor - Helen Taussig, a specialist paediatric cardiologist rightly considered by some as the "Queen of hearts".
Her dedicated team was puzzled by the short lived , strikingly blue skinned babies which they called the "crossword puzzles" . She could decipher a part of the puzzle - the death was due to lack of oxygen - as revealed by careful autopsies. Obviously, something in the heart was hindering the process of oxygenation - the mixing of deoxygenated and the oxygenated blood at the level of the ventricles was probably the reason.The valve of the pulmonary artery through which the blood from the heart reached the lungs ( where it got oxygenated and purified) was narrowed.
Taussig now looked for the possible solution. When no obvious solution was found in the living children, she started to look at the answer for the misery of blue babies in the fetal circulatory system. Ductus arteriosus was a special path to bypass the unnecessary trip of the blood to the lungs ( as the lungs never oxygenate the blood in the fetus).But once the baby began breathing, the lungs start oxygenating and ductus and other similar paths normally closed.
Taussig noticed that the blue color intensified when the ductus began to close. She made a clever observation - the children still needed the ductus( for their survival. ) but for a reverse purpose. The normal process of the closure of ductus sealed off the path of the blood to the lungs and virtually killed the baby preventing any oxygenation / purification of the blood. If kept open in the blue babies after birth, the ductus gave one more chance for the deoxygenated blood to get purified. She was thrilled to have found a way to keep them alive longer!
Now she had to find a surgeon who would agree with her ideas, believe her and do the surgery boldly. No one had thought of this or done this surgery before! Taussig had heard of a doctor who had daringly entered the hear of a young girl to seal off an improperly closed ductus. If he could seal off one, she reasoned, he could be convinced to create one. She went to Boston in 1940 to meet him. In her own words, she was devastated to find that " he was not in the least interested" in the possibility of building a ductus
Then it so happened that a nationally known and acclaimed vascular surgeon Alfred Blalock joined Johns Hopkins hospital. She was in awe of him when she witnessed him close a ductus successfully. She said to him " but the really great day will come when you build me a ductus for a child who is dying because too little blood is going to the lungs".
Accepting here cahllenge, Blalock started experimenting on dogs. After doing so on hundreds of dogs, finally he was ready for the first patient in early 1944.
The concept involved in the surgery was simple - to choose a major artery stemming from the aortic arch and join it to the pulmonary artery. This procedure sent some of the blood back to the lungs. The result was spectacular and was there for every one to see!
"I walked to the head end of the table ', Taussig recalled of an operation on a young boy "and there he was with bright pink cheeks and very red lips"! Blalock - Taussig shunt was born and many children got a new lease of life.
Allthis was possible due to the careful observation and logical deduction by a compassionate doctor - Helen Taussig - "Queen of hearts" indeed!
Her dedicated team was puzzled by the short lived , strikingly blue skinned babies which they called the "crossword puzzles" . She could decipher a part of the puzzle - the death was due to lack of oxygen - as revealed by careful autopsies. Obviously, something in the heart was hindering the process of oxygenation - the mixing of deoxygenated and the oxygenated blood at the level of the ventricles was probably the reason.The valve of the pulmonary artery through which the blood from the heart reached the lungs ( where it got oxygenated and purified) was narrowed.
Taussig now looked for the possible solution. When no obvious solution was found in the living children, she started to look at the answer for the misery of blue babies in the fetal circulatory system. Ductus arteriosus was a special path to bypass the unnecessary trip of the blood to the lungs ( as the lungs never oxygenate the blood in the fetus).But once the baby began breathing, the lungs start oxygenating and ductus and other similar paths normally closed.
Taussig noticed that the blue color intensified when the ductus began to close. She made a clever observation - the children still needed the ductus( for their survival. ) but for a reverse purpose. The normal process of the closure of ductus sealed off the path of the blood to the lungs and virtually killed the baby preventing any oxygenation / purification of the blood. If kept open in the blue babies after birth, the ductus gave one more chance for the deoxygenated blood to get purified. She was thrilled to have found a way to keep them alive longer!
Now she had to find a surgeon who would agree with her ideas, believe her and do the surgery boldly. No one had thought of this or done this surgery before! Taussig had heard of a doctor who had daringly entered the hear of a young girl to seal off an improperly closed ductus. If he could seal off one, she reasoned, he could be convinced to create one. She went to Boston in 1940 to meet him. In her own words, she was devastated to find that " he was not in the least interested" in the possibility of building a ductus
Then it so happened that a nationally known and acclaimed vascular surgeon Alfred Blalock joined Johns Hopkins hospital. She was in awe of him when she witnessed him close a ductus successfully. She said to him " but the really great day will come when you build me a ductus for a child who is dying because too little blood is going to the lungs".
Accepting here cahllenge, Blalock started experimenting on dogs. After doing so on hundreds of dogs, finally he was ready for the first patient in early 1944.
The concept involved in the surgery was simple - to choose a major artery stemming from the aortic arch and join it to the pulmonary artery. This procedure sent some of the blood back to the lungs. The result was spectacular and was there for every one to see!
"I walked to the head end of the table ', Taussig recalled of an operation on a young boy "and there he was with bright pink cheeks and very red lips"! Blalock - Taussig shunt was born and many children got a new lease of life.
Allthis was possible due to the careful observation and logical deduction by a compassionate doctor - Helen Taussig - "Queen of hearts" indeed!
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