title: When did cardiac surgery begin?
abstract: Heart surgery is generally regarded as having begun on September 10, 1896 when Ludwig Rehn sutured a myocardial laceration successfully. There are valid reasons, however, to believe that cardiac surgery had its origin nearly a century earlier with the operative drainage of the pericardium by the little known Spanish surgeon, Francisco Romero, and highly regarded Baron Dominique Jean Larrey. This procedure entailed making a thoracic incision and opening and draining the pericardium. It must necessarily be considered a cardiac operation. The pericardium is part of the heart; its epicardium continues as the serosal layer of the fibrous pericardium; the pericardium is fused to the heart's base and great vessels; all books on heart surgery include pericardial operations. When Romero first operated is unknown, but it antedated 1814 when his work was presented in Paris; Larrey's operation was performed in 1810. These contributions are presented, and their priority with regard to the later initial efforts to suture myocardial laceration is reviewed briefly.
authors.affiliation: Department of Surgery, the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: H B
authors.initials: HB
authors.lastname: Shumacker
mesh_terms: D006348:Cardiac Surgical Procedures / Q000266:history*; D049672:History, 19th Century; D049673:History, 20th Century