Word: hearted
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Dates: during 1960-1969
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Some U.S. physicians asked last week whether the flurry of surgical virtuosity in heart transplants might be premature. A Canadian heart surgeon said it was. The Soviet Union's health ministry forbade Russian surgeons to do such transplants. Germany's Dr. Werner Forssmann, who won a Nobel Prize for dangerously daring heart research performed on himself, said: "I consider it a crime to perform an operation in a field where fundamental research is not yet finished...
Although the heart surgeons who had performed transplants obviously did not agree, they made no secret of their concern over the ethical problems involved. Dr. Shumway describes the procedure not as an experiment but as a "clinical trial." He does not expect heart transplants ever to become routine, partly because of the problem of supply, but he looks forward to the day when they can be considered effective treatment for selected patients...
...question then arises: For which patients? A basic rule in surgery is: "Never perform a big operation if a smaller one will do." No smaller, less radical operation offered any hope for any of the first five recipients of heart transplants. They were all patients whose condition was judged to be "terminal," whose end might come any day. In those circumstances, Shumway's "clinical trial" can be ethically justified...
Scratching the Heart. What the surgical spectaculars have done, though nobody planned it that way, is to divert attention-and possibly research money-from corrective measures for heart disease in its earlier stages, and ultimately, of course, from prevention. There are already several surgical approaches designed to repair hearts after coronary occlusion but before the damage becomes near-total and irreversible, as it had in the transplant patients...
...oldest of these, pioneered 30 years ago by Cleveland Surgeon Claude S. Beck, involves opening the heart sac and scratching the heart's surface, so that in self-defense it builds up an increased blood supply. A second technique devised by Montreal's Dr. Arthur Vineberg requires ihe freeing of minor arteries in the chest and implanting these in the heart muscle.* More radical is the removal of a pie-cut wedge of damaged heart, after which the edges of healthy muscle are stitched together. There are, in addition, several methods of reaming atherosclerotic plugs from coronary arteries...