September 2, 1952

Cardiac surgery

F. John Lewis's Team Performs the First Successful Direct-Vision Open-Heart Operation

Surgeons spent two hours and ten minutes cooling a five-year-old for a repair that had to be finished in five and a half minutes.

Cooled to 28°C, then opened

At the University of Minnesota on 2 September 1952, surgeon F. John Lewis led the first successful operation inside a human heart under direct vision in a dry operative field. The patient was five-year-old Jacqueline Johnson, who had a congenital atrial septal defect — a two-centimetre hole between the heart's upper chambers.

The team spent two hours and ten minutes cooling the anesthetized child to roughly 28°C, about 82°F, reducing her metabolic and oxygen requirements before interrupting blood flow into the heart.

There was no heart-lung machine. Hypothermia alone bought the minutes the surgeons needed.

Five and a half minutes of occluded inflow

Lewis opened the right atrium and closed the septal defect under direct vision while cardiac inflow was occluded for about five and a half minutes. The heart was not chemically arrested; emptied of blood, it went on beating slowly through the repair.

Afterwards the team rewarmed the child in a 45°C water bath. Circulation was restored and her postoperative recovery was uneventful.

The surgical team included first assistant Richard L. Varco and second assistants Mansur Taufic and C. Walton Lillehei.

The qualifiers the phrase 'first open-heart surgery' drops

Earlier surgeons had opened or operated on the heart, and unsuccessful intracardiac attempts preceded this case. The defensible claim is narrower: first successful direct-vision operation inside an open human heart in a dry field.

Nor did the case prove complex repairs were now possible. Surface hypothermia gave roughly eight to ten minutes, which suited a relatively straightforward septal defect and little else.

Retrospective accounts often pair Lewis and Lillehei as co-leads. Lewis led; Lillehei was one of two second assistants, and his controlled cross-circulation work came in 1954.

Sources

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What the sources leave uncertain

“First open-heart surgery” is too broad unless qualified. Earlier surgeons had opened or operated on the heart, and unsuccessful intracardiac attempts preceded this case. The defensible distinction is the first successful direct-vision operation inside an open human heart in a dry field.
Some retrospective accounts foreground only Lewis and Lillehei, but the documented operating team also included Richard Varco and Mansur Taufic, with Lewis leading.