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Cardiovascular Surgery

Our history

Our roots  |  The formal era  |  The roaring 80s  | The new millennia


Our roots

The Hospital for Sick Children was founded in 1875, and just slightly over 60 years later in 1938, Dr. Keith was named physician-in-charge of the cardiac department, a department that was virtually non-existent before his arrival. At that time, heart disease in children was mainly diagnosed as rheumatic in origin and relatively little was known about congenital heart disease. Dr. Taussig had earlier established a cardiac clinic at the Johns Hopkins Hospital in Baltimore, Maryland, and Dr. Abbott of Montreal had compiled 1,000 cases of congenital heart disease, published in atlas form in 1936.

 

The formal era - 1930s to 1970s

Perhaps the formal era of congenital heart disease was ushered in by Dr. Gross of the Children's Hospital in Boston who first successfully ligated the patent arterial duct in 1938. By 1945, the contribution of Taussig and Blalock to the surgical palliation of cyanotic congenital heart disease with reduced pulmonary blood flow had tremendously widened the scope of surgical intervention for congenital heart disease. In the early 1950s in Toronto, Dr. Mustard abandoned a most promising career in orthopedic surgery to assume the newly-created position of head of the section of children's heart surgery at The Hospital for Sick Children. During the early 1950s, Dr. Keith recruited Drs. Rowe and Vlad. During the mid- and late 1950s Drs. Keith, Rowe, Vlad and Mustard published extensively on many forms of congenital heart disease, focusing attention on clinical and angiocardiographic diagnoses and surgical outcomes. The first edition of the now classic textbook Heart Disease in Infancy and Childhood written by Drs. Keith, Rowe and Vlad was published in 1958 and the 3rd and final edition in 1978.

Dr. Mustard in 1955 attempted the first anatomic repair for complete transposition of the great arteries, but his attempts were unsuccessful. A benchmark contribution to cardiac surgery and to the care of patients with complete transposition of the great arteries was Mustard's physiological baffle repair first carried out at The Toronto Hospital for Sick Children on May 16th, 1963. This procedure consisted of a baffle sewn within the atrium to divert the systemic venous blood to the mitral valve, left ventricle and pulmonary artery and pulmonary venous blood to the tricuspid valve, right ventricle and aorta. This venous switch procedure revolutionized the outcome for many patients with complete transposition of the great arteries, and was one of the operations of choice for these patients until the first successful arterial switch procedure was carried out by Dr. Jatene of Sao Paulo, Brazil in 1975.

Dr. Van Praagh, a native Torontonian, took his paediatric and cardiology training at The Hospital for Sick Children, and some of his important contributions on the segmental approach to congenital heart disease including those papers on the anatomy and diagnosis of single ventricle and dextrocardia emanated from this institution. Dr. Trusler joined Dr. Mustard in 1958, succeeding him as divisional head in 1976.

The two surgeons were joined by Dr. Williams in 1973, and Dr. Williams succeeded Dr. Trusler as head of the in 1989. Dr. Olley joined the division of cardiology in 1967, and with Dr. Coceani showed in 1975 that an E-type prostaglandin could maintain patency of the arterial duct, a novel contribution that dramatically contributed to enhance the outcome of patients with duct-dependent congenital heart disease. Dr. Rowe who succeeded Dr. Taussig as chief of the division of pediatric cardiology at Johns Hopkins in 1973 returned to Toronto in 1973 to succeed Dr. Keith as director of the division of cardiology.

With the recruitment of Dr. Rowe, the staffing of the division continued to improve, and clinical activities continued to expand. Sections within the division were established to include the catheter laboratory; heart station and electrophysiology; echocardiography; cardiac pathology; cardiovascular research; and education and administration. Dr. Olley was named the first head of the Cardiovascular Research focus in the Research Institute of The Hospital for Sick Children in 1981, and remained in that position until he relocated to the University of Alberta in Edmonton as professor and chair of the department of paediatrics.

 

The roaring 80s and 90s

Dr. Rabinovitch joined the division of cardiology in 1983, and assumed the position as head of the Cardiovascular Research focus on the departure of Dr. Olley. Dr. Freedom had been recruited from Boston Children's Hospital to join Dr. Rowe at Johns Hopkins, and Dick then asked him to join him in Toronto in 1974, succeeding Dr. Rowe as division head in 1985. Dr. Smallhorn joined the division of cardiology in 1983, and built the section of echocardiography into a unique institutional and Canadian resource. Dr. Benson joined the division of cardiology in 1982 as head of the Variety Club Cardiac catheterization laboratories. Under his leadership, he has developed a program recognized globally for contributions to interventional and therapeutic cardiac catheterization. Dr. McCrindle joined the division in 1991 and with his background in biostatistics and study-design has added a new dimension to the many studies emanating from our unit.

The Congenital Heart Surgeons Study data base relocated from Birmingham, Alabama to The Hospital for Sick Children in 1999, and this study is now chaired by Dr. Williams and the statistical support provided by Dr. McCrindle. Under the leadership of Drs. Benson and Coles, a cardiac transplant program was inaugurated in 1989 when the first heart transplant was carried out. This program has continued to flourish and currently staff cardiologists are involved with the care of the cardiac transplant patients.

 

The new millennia

Dr. Van Arsdell was recruited to Cardiovascular Surgery in 1996 and became Head in 2001.

Dr. Bill Williams retired as an operating surgeon at the end of June 2006 but is continuing to be involved with database work and epidemiologic research, as Director of the CHSS.

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