Innovations in Heart Medicine

One of the photographic studies done by Yousuf Karsh to mark the official "1000 blue baby" procedure performed by Alfred Blalock. Portrait by Yousuf Karsh, ©Karsh

In 1944, doctors at Johns Hopkins performed the surgery that opened the door to today's heart surgery. Working together, The Johns Hopkins Hospital's chief surgeon, Alfred Blalock, lab supervisor Vivien Thomas, chief surgical resident William Longmire, surgical intern Denton Cooley, nurse Charlotte Mitchell and pediatric cardiologist Helen Taussig devised a means to improve blood oxygenation by connecting one of the heart's major arteries with another feeding into the lungs.

Known as the ”Blue Baby operation,” the procedure was first performed on a tiny, 18-month-old girl suffering from tetralogy of Fallot (blue baby syndrome), a combination of heart defects that kept her blood so starved for oxygen that she appeared blue. In time, the Blue Baby operation not only helped save the lives of thousands of similarly afflicted children around the world, but also opened the door to now-familiar procedures like coronary bypass surgery.

In the 1950s, doctors and scientists at Johns Hopkins developed the first cardiac defibrillator and the technique for manual cardiopulmonary resuscitation, or CPR. While electric defibrillators are a familiar presence of hospital emergency rooms and ambulances, CPR has been credited with saving hundreds of thousands of lives.

In the 1970s, researchers at Hopkins helped refine pacemaker technology when they invented the first implantable device that could actually be recharged inside the body. A decade later, they invented the implantable cardioverter defibrillator (ICD) to help those with unpredictable and potentially fatal irregularities in their heartbeat.

Helen Taussig examines an infant. Portrait of Helen B. Taussig by Yousuf Karsh, ©Karsh

Over that same time,other research at Hopkins helped improve the diagnosis and treatment of heart disease by working both outside and inside of the heart. Small probes that could be threaded through veins and arteries gave heart doctors a way to actually see and work inside the heart, making a range of new diagnoses and treatments possible. Known as cardiac catheterization, the technique created a new field in cardiology known today as interventional radiology.

In the 1980s cardiac specialists at Johns Hopkins working with children developed balloon angioplasty: inserting a balloon-tipped probe into the arteries feeding the heart, and then inflating it to clear blockages. The technique quickly became a common procedure for the treatment of adult heart problems.

Heart doctors at Johns Hopkins also advanced the field of clinical genetics. Victor McKusick was intrigued by the clustering of abnormalities he saw in heart patients, particularly those with Marfan syndrome, a genetic disorder that affects connective tissue and often damages the aorta. He began studying genetics and mapping the locations of genes, tracking how their abnormalities expressed themselves and caused disease.

McKusick’s research at Hopkins expanded to include hundreds of other genetic disorders as well. He established a link between genetic disorders and certain medical problems, opening the door to modern gene therapy. Today, doctors are no longer limited to treating the symptoms of inherited diseases — including some forms of heart disease — but are working to resolve them through gene therapy and gene replacement.

Alfred Blalock and his surgical team, performing one of the first shunts.

That tradition of pioneering work continues at Johns Hopkins with physicians and researchers working in almost every field related to cardiovascular disorders, from transplant surgery to heart disease prevention.

Each year the National Institutes of Health awards ten SCORE (specialized center of research excellence) grants in heart research to medical institutions nationwide. Cardiologists at Johns Hopkins have won two SCORE awards for their studies of coronary artery disease and the causes of sudden cardiac death.