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Brain Cancer - Rev. Jonathon Kennedy   Breast Cancer - Angela Adler Breast Cancer - Elaine J. Douglas   Type I Diabetes - Erika Burr Diaphragmatic Hernia - Nancy   Heart Surgery - Jeff Salzwedel Multiple Sclerosis - Ramona M. & Barbara W.   Parkinson’s Disease - Gordon Coggshall

HEART SURGERY We hardly bat an eye these days when we hear that a friend has had open heart bypass surgery. Years of animal research made the now commonplace procedure possible. JEFF SALZWEDEL The press conference was intended to announce that Portland physician Albert Starr, M.D., had made a major breakthrough in cardiac surgery. But the cameras and strobe lights were fixed on 5 year-old Jeff Salzwedel and dog named Duke. Jeff had just undergone a pioneering corrective heart surgery that was first practiced on Duke. The surgery bought Jeff enough time to grow up so that as an adult he could receive an artificial heart valve. That was 35 years ago. Today Jeff is a retired Portland stockbroker, husband of Tracy and father of 10 year-old Austin, 8 year-old Alex, and 5 year-old Jessie. Without the artificial heart valve, he would have been an invalid and might have lived only a few years. And Duke, who retired from medical research after he was named research dog of the year, came home with Jeff where he remained the family pet for eight years. The first heart valve was invented by Oregonians Lowell Edwards and Dr. Starr. Today's heart valve implants, placed in about 100,000 persons each year, are much improved thanks to years of continued research and engineering in which sheep played an important role. Research with animals has brought about the development and modification not just of cardiac valves, but also of vascular grafts, prosthetic joints, internal defibrillators, and even mechanical hearts. Such research also made the very procedure of open-heart surgery possible. "When I was five," says Salzwedel, "I didn't understand the seriousness of my condition or the reality that without the surgery and the eventual valve replacement I wouldn't live much longer. I certainly didn't understand how my life depended on a long history of animal research. I just knew that Duke was part of the reason I was well, and I was very grateful." In open heart surgery a heart lung machine takes over the function of the heart with a pump and the function of the lungs with an oxygenator. This allows surgeons to replace diseased arteries or defective valves, which often takes several hours, to be carried out in relative safety. The technique of open heart surgery involves opening the chest and catheterizing the veins carrying blood returning to the heart from the circulation system. This deoxygenated, venous blood is collected in a reservoir, then passed through an oxygenator. The freshly oxygenated blood is pumped back into the arterial circulation through a convenient artery. Thus an adequate supply of oxygenated blood is maintained to the vital organs. The heart and the lungs are therefore out of circulation, having been bypassed by the mechanical pump, functioning as the heart, and the oxygenator, standing in for the lungs. The first heart bypass was performed on a cat by J. H. Gibbon in 1934. Heart specialists conducted a series of experiments with dogs between 1939 and 1945 to see if prolonged passage of blood though an artificial lung would have any deleterious effect. It wasn’t until 1964 that surgeons, including the renowned Michael DeBakey, performed the first successful coronary bypass in a human patient. Another surgeon, D.G. Melrose, achieved elective cardiac arrest in anaesthetized dogs on a heart-lung machine. Subsequent experiments with rabbits and rats helped doctors learn how to prevent damage to a heart undergoing heart attack by stopping heart action as rapidly as possible. Are animal models still needed for heart research? Heart lung machines, cardiac valves, vascular grafts, prosthetic joints, internal defibrillators, mechanical hearts and even catheters -- all have been made possible through animal research. No device is perfect. The quest for a perfect heart valve, for example, will continue into the future, and part of that quest will be the need for animal models, most likely sheep, to complement computer tests of their efficacy. No procedure is "as far as we can go" in treating heart disease. A new procedure being studied in pigs by researchers here in Oregon, for example, is the use of laser catheters as "clot busters." Finally, basic research with animals will continue to explore the roles of genes, hormones and diet in cardiovascular health. Heart Disease: * is the leading cause of death in the Western World. * afflicts 1 in 4 Americans in forms ranging from high blood pressure to hardening of the arteries. * treatment has been advanced by knowledge of blood groups and blood typing: development of surgical procedures such as catheterization and open heart surgery; production of medical devices such as pacemakers and heart valves; and use of antibiotics and anti-rejection drugs, both essential to heart surgery - all dependent on animal research.

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