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Author Topic: Dr. DeBakey  (Read 1413 times)
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Sam
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« on: July 13, 2008, 05:58:13 PM »

One of my heroes.

http://www.chron.com/disp/story.mpl/front/5885921.html


 July 13, 2008, 2:52PM
DeBakey presided over transformation of medicine

By ERIC BERGER
Copyright 2008 Houston Chronicle
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HONORING DR. DEBAKEY

Funeral services for DeBakey will be at 11 a.m. Wednesday at St. Luke's United Methodist Church, 3471 Westheimer. DeBakey is to lie in repose within the rotunda of Houston City Hall from 10 a.m. to 7 p.m. Tuesday, officials at Baylor College of Medicine said. The viewing is open to the public.
Images from a remarkable career
'A valiant surgeon'

The 1930s — when Dr. Michael E. DeBakey attended medical school — opened with Dr. Karl Landsteiner winning a Nobel Prize for his discovery that humans had different blood types.

The best microscope of the day could magnify slides by a factor of about 2,500, barely enough to see even the largest viruses. Antibiotics to treat infections were nearly a decade away. Doctors had access to simple X-rays, but more commonly relied upon the trusty stethoscope.

Heart surgery was unthinkable.

"The main therapy for patients who suffered a heart attack was rest," said Dr. Stanley Reiser, a professor and MD at George Washington School of Medicine and Health Sciences.

It was in this world that DeBakey came of age. He earned his bachelor degree from Tulane University in 1930, and become a medical professor there in 1937.

Partly through his own inventive and surgical talents, and partly due to the longevity of his seven-decade medical career, DeBakey presided over the transformation of medicine from a relatively rudimentary practice into today's highly specialized care.

He helped usher in the era of big surgery — large incisions to reach the uncharted heart, aorta and other vital organs — then practiced medicine long enough to see that phase begin to wane in the face of today's push for minimally invasive surgery.

DeBakey — considered by many to be the greatest surgeon ever — died Friday night at The Methodist Hospital in Houston. He was 99.

Methodist officials said DeBakey died of natural causes.

After coming to Houston in 1948, DeBakey described the state of surgery in this city during an interview with the American Journal of Cardiology. At the time, surgery was just becoming a specialty among doctors, requiring certification and formal training.

"When I first came to Houston, all general practitioners were doing surgery, and often doing it poorly," DeBakey recalled.

"The first time I came here, they had a meeting over at the old Jefferson Davis Hospital, and one of the doctors there presented a paper on a new technique for hernia operation. You know what it was? Removal of the testicle and sewing of the opening. I was so stunned that when they asked me to comment on it, I said 'I don't know what to say about this.' The particular surgeon performed this operation on some patients with bilateral hernias. Think of that!"

Until the 1950s, heart surgery was limited to procedures quickly done as the brain survived without oxygen only about four minutes.

Such a deficiency prompted Dr. John Gibbon — with the assistance of a roller pump DeBakey had conceived during his schooling at Tulane — to develop the first successful heart-lung machine in 1953. It was the nudge heart surgery needed.

"The heart-lung machine, you might say, opened the horizon because it demonstrated that you could replace the function of the heart and lungs temporarily," DeBakey said in a 2005 interview. "Once you can do it for a few hours, it's not a great step in your imagination to think, 'Why can't we do this for a few days, weeks, months or more?'"

In the next two decades innovation flourished. With DeBakey at the forefront, cardiac surgeons developed the coronary bypass, heart transplants and a host of other surgical techniques still used to treat the heart in modern operating rooms.

Though known mostly as a heart surgeon, DeBakey may have made his greatest surgical contributions as a vascular surgeon, treating the body's main artery. He made the aorta, which carries blood from the heart to the body, a treatable entity. Aneurysms, or blockages, and dissections, tears in the aortic wall, were almost universally fatal in 1950.

His development of Dacron grafts, in conjunction with the heart-lung machine, made vascular surgery possible. Surgeons now could replace sections of the artery. In 1952 DeBakey became the first U.S. surgeon to remove an aneurysm in the aorta near the stomach, and replace it with a Dacron graft. A year later he did so with an aneurysm in the chest, much nearer the heart. Along with local doctors such as Denton Cooley and Stanley Crawford, DeBakey built Houston into a world leader for heart and aortic surgery.

By then, however, the seeds of the next revolution in medicine — minimally invasive surgery — already had been sown.

In 1929, a German student named Werner Forssmann sensationally injected a catheter into his arm and slid it up a vein. An X-ray showed that the slender tube had snaked its way into his heart.

By the 1980s, with the advent of MRIs and other imaging advances, the potential for this type of non-invasive therapy to mend hearts and arteries was apparent. DeBakey authored a foreward to the 2006 textbook, Endovascular Therapy — Principles of Peripheral Interventions.

"Once this concept was recognized, an increasing number of investigators from a variety of disciplines, ranging from surgery, cardiology and radiology to bioengineering and industrial technicians, focused their interest and energies on implementing this concept with rapidly improving clinical results," he wrote.

Today, with vastly improved imaging and techniques, catheterization has become the single-most common procedure in U.S. hospitals, with about 4 million done a year to diagnose and treat problems of the heart and arteries.

Its rise has led to a steady decline in the number of coronary artery bypass surgeries performed each year.

eric.berger@chron.com
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