Origins and Evolution of Extracorporeal Circulation: JACC Historical Breakthroughs in Perspective

J Am Coll Cardiol. 2022 Apr 26;79(16):1606-1622. doi: 10.1016/j.jacc.2022.02.027.


Midway through the 20th century, direct open-heart operations were not yet a reality, awaiting safe methods to support the cardiopulmonary circulation during cardiac surgery. The scientific advancements collectively leading to safe cardiopulmonary bypass are considered some of the most impactful advances of modern medicine. Stimulated by the work of physiologists and engineers in the late 19th century, primitive pump and oxygenator designs were the forerunners of major work by DeBakey and others in roller pump design and by Gibbon in oxygenator development. Following Gibbon's historic successful closure of an atrial septal defect in 1953 with his heart-lung machine, it was left to Lillehei and Kirklin to first successfully repair large series of cardiac malformations. The history leading to these historic events and the subsequent evolution of cardiopulmonary bypass machines for short- and longer-term support is filled with engineering and surgical brilliance, daring innovations, and serendipity.

Keywords: cardiac surgery; cardiopulmonary bypass; circulatory support; extracorporeal circulation; heart-lung machine.

Publication types

  • Historical Article
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Surgical Procedures* / history
  • Cardiopulmonary Bypass
  • Extracorporeal Circulation
  • Heart Defects, Congenital* / surgery
  • Heart-Lung Machine / history
  • History, 20th Century
  • Humans