Baker 1

Tabitha Baker

Professor Malcolm Campbell

UWRT 1103

September 21, 2019

Topic Proposal: How is Cardiac Surgery Evolving with Modern Technology?

Introduction/Overview

The topic that interests me is cardiac surgery and the future of the field. I will be

examining the evolution of cardiac surgery and the potential it shows for future generations in

combination with modern technology and advancements in the surgical field. To gather some

initial background information, I first wanted to know when cardiac surgery began, where it

began, and who began the process of surgical procedures on the heart.

Cardiac surgery is a relatively new development in the medical field, only beginning in

1943 in the middle of World War II due to Dwight Harken, an American captain in the medical

corps. According to the American Heart Association in their journal “The Past 50 Years of

Cardiovascular Surgery,” Harken retracted foreign bodies from inside the hearts and around the

hearts of more than 100 soldiers. Due to these actions, Harken paved the way for cardiovascular

surgery to acquire serious and effective developments. I am interested in how cardiac surgery has

evolved from this and how it will continue to evolve in the future.

There are currently many differing opinions surrounding the future of cardiac surgery

circulating around the medical field. According to “Cardiac Surgery and the Future” by David

Yaffee and Matthew Williams, “Cardiac surgery has been described as a dying specialty with the

astronomical growth of the field becoming overshadowed by its impending decline.” With
 Baker 2

minimally invasive techniques becoming more and more popular, some are claiming that these

will be shifting “away from open surgery toward the interventional techniques already dominated

by other specialties.” Yaffee and Williams dispute this claim in their article, stating, “However

this shift in practice signals not a slide into obsolescence but a new chapter in the history of a

field still in its adolescence.” Due to cardiac surgery being such a new field within medicine, it is

important to remember that there are still many developments that have yet to be uncovered. For

example, operations on the mitral valve showed “decreased pain, bleeding, functional limitation,

and hospital length of stay, as well as improved cosmesis and quality of life, with outcomes

similar to traditional approaches” due to telemanipulative instrumentation with robotic devices.

However, as of 2015, many hospitals and specialists have not adopted this approach in the

United States.

Initial Inquiry Question(s)

How is cardiac surgery evolving with the use of modern technology? How has cardiac

surgery changed over the last 50 years? How are robotics projected to change the field of cardiac

surgery? What research is currently being conducted to help make cardiac surgery more efficient

and more effective? Where is the fine line between “invasive” and “minimally invasive”

surgeries? What kind of differing opinions currently exist in the medical field regarding the

future of cardiac surgery? What are the statistics for incoming cardiac surgeons/specialists? Is

the number of these specialists increasing or decreasing?

My Interest in this Topic

When my father had a heart attack in September of 2000, it had been exactly six years

and one day since his own mother suffered a heart attack and died on the operating table while
 Baker 3

receiving an angioplasty— the process of putting a stent in her coronary artery to prevent it from

narrowing again. When the doctors told my father that he would have to have the same

procedure done, he, a man that I have not witnessed cry once in my 18 years, burst into tears.

With two young sons at home and a baby on the way, I can only imagine the fear that gripped

him. For my mother’s part, this was the fourth time in her life that she had to linger in the

waiting room while a member of her family underwent cardiac surgery. Despite there only being

a six-year difference between my father’s procedure and his mother’s, he came out of the

operating room alive and mostly well. Whether that was due to six years of medical advances or

simply the difference in hospital locations, none of us have ever known.

With four family members suffering from heart attacks in the last forty years, two of

them dying due to this, and another receiving an angioplasty in order to prevent a heart attack, it

cannot be denied that I am genetically predisposed to this condition. On top of this, years after

his own heart attack, my grandfather had open heart surgery with a quadruple bypass. There is a

probable chance that I will be in a waiting room again while my own father is on an operating

table, and this time I will not be blissfully unaware in my mother’s womb. There is a probable

chance that I will be in a waiting room while one of my brothers is on an operating table. There

is a probable chance that some day I will be the one on the operating table, as much as I try to

prevent it. I need to know what options await all of us.

I know a little more than the average person about heart attacks, and I know next to

nothing about cardiac surgery, excluding the procedure my father had, which was minimally

invasive. I hope to learn more about the history of cardiac surgery, and the future that will come

in the field. I also want to learn how robotics are projected to change the field of invasive cardiac

surgery. I want to learn how rapidly research is progressing. Did those six years truly make that
 Baker 4

much of a difference? Or did the hospitals/doctors differ that greatly? Could it have been the age

difference between my father and his mother, who were 47 and 65, respectively, at the time of

their angioplasties?

Next Steps

Going forward, I will be seeking out the latest research. For current research, I am putting

a time restriction on books and articles from 2018-present due to the quick pace of research in

the medical field. However, in order to understand the present, I must understand the past, so I

will also be using resources such as The Evolution of Cardiac Surgery by Harris B. Shumacker. I

will be utilizing the reference librarians at Atkins Library. I will be more thoroughly dissecting

the American College of Cardiology Foundation’s article, “Cardiac Surgery and the Future,”

along with other useful and credible articles I find, especially from the Atkins website. I will also

be combing through the cardiology journals from the American Heart Association

(ahajournals.org).