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Expert Care With a Lot of Heart: A History of Pediatric Heart Surgery

Published on Feb. 01, 2021

I arrived at the old Valley Children’s Hospital in downtown Fresno over forty years ago, excited about the prospect of a fulfilling career in the scientifically fascinating, emotionally rewarding and (at the time) relatively new field of pediatric cardiology. I knew then that our heart services were outstanding. Despite our modest size and rural California setting, we were very early adopters of heart technology and clinical expertise. 

Some may assume that our modern Willson Heart Center just spontaneously evolved in its present state of excellence. But there is a long and dramatic history going back in time to 1955, involving caring volunteers, dedicated professionals and an upward trajectory of technology – which now allows us to provide the finest cardiac care available – right here in our own neighborhood.
 

Dr. Prochazka in the cath lab
 

Consider that the world’s first open heart surgery was in 1952 at the University of Minnesota -- the same year Valley Children’s opened. Only three years later, in 1955, Dr. Byron Evans and the original heart team at Valley Children’s performed the first procedures on blood vessels outside of the heart.

By 1958, a successful repair of an atrial septal defect - abnormal communication between the upper chambers of the heart - was performed.

In the following years, the caring team at Valley Children’s continued to acquire the technology necessary to maintain excellence in heart care. Consider these milestone achievements:

  • In 1958, our first cardiac catheterization laboratory opened, with images of the heart obtained by using an X-ray film cassette changer, which would rapidly (and noisily) capture the flow of blood through the heart to identify defects. (Compare this early technique with the high-resolution electronic, X-ray videos of today.)
  • The Kay Anderson Vertical Screen Oxygenator was purchased in 1959. Teams were assembled for many practice trials involving new techniques to perform a cardiac bypass. By 1960, the first open heart surgeries were performed using our new cardiopulmonary bypass capabilities.
  • The 1970s brought the greatest advance in my career for the diagnosis of heart defects. With the arrival of cardiac ultrasonography, also known as echocardiography, we were able to see the earliest images of an infant’s heart. Valley Children’s became the first pediatric echocardiography laboratory to achieve certification in North America. Early on, images were fuzzy with narrow views compared to the 3D technology of today, which shows the heart structure and function with amazing clarity.
  • Also in the 1970s, Valley Children’s opened the Human Performance Metabolic Exercise Laboratory for children, which helped a care team better understand the function of the heart and circulatory system not only with when a child is resting, but during intense exercise.
  • The 1970s also brought the new field of interventional pediatric catheterization to Valley Children’s. It is now possible, and even routine, to repair selected congenital heart defects without open heart surgery – by using catheterization techniques. This means no chest incision or scar, no need to stop the heart to use cardiopulmonary bypass, no blood transfusion, a shorter hospital stay and rapid recovery. These procedures for children were pioneered in Central California at Valley Children’s. 
  • More recently, with the help of our Valley Children’s Guilds, we have accepted the challenge of transitioning our adolescent patients to adult-centered care. With endless medical and surgical advances, more children with complex conditions are now surviving to adulthood and life-long care needed. To meet this need, Valley Children’s Healthcare has developed an adult congenital heart disease (ACHD) program staffed by trained nurse educators and pediatric and internal medicine certified ACHD specialists. 

Our capabilities at the Willson Heart Center have expanded as the entire Valley Children’s Healthcare network has grown to reach all children in our service area. In the short time of just 65 years, we have developed from a small hospital with a huge mission to one of the largest pediatric healthcare networks in the nation. We are able to offer the Central Valley access to every pediatric subspecialty at multiple outreach clinics and by telemedicine. 

We have progressed to award-winning status for our neonatal and pediatric intensive care units, and our record of delivering safe care is among the best in the nation. In my many years at Valley Children’s I have personally witnessed our amazing growth in the fulfillment of our sacred mission. 

In a troubled world, we can all be proud of these mighty collective accomplishments, representing the best we can offer kids in the Valley.

 

by James V. Prochazka, MD, FAAP, FACC
Pediatric Cardiology, Valley Children’s Willson Heart Center

 

February is Heart Month