ABSTRACT
In 1925 Sir Henry Souttar reported the first mitral commissurotomy in the British Medical Journal. He wrote that the heart should be as amenable to surgery as any other organ and that many of the problems in heart disease were, to a large extent, mechanical. He saw the main problem as being maintenance of blood flow, particularly to the brain, while surgery was being performed. The first real advances occurred in the late 1940s and early 1950s, driven by surgeons who had gained confidence and experience under the pressures and opportunities provided by war. Further progress waited upon the development of cardiopulmonary bypass in the mid-1950s. Now the number, range and technical complexity of heart operations are remarkable; with the heart restored to good working order, the well-being and lifespan of patients with congenital, valvular and degenerative heart disease can be very much improved.
