Introduction

There are different ways of going down in history of humankind. You can become a general and win a battle, you can publish a novel and win a Nobel Prize, you can describe a new disease or find a drug against it… 65 years ago Cecelia Bavolek went down in history as the first patient to have a congenital heart defect corrected with the use of the heart-lung machine (figure 1). This event marked the beginning of open-heart surgery.

In 1812, French physiologist Julien Jean César Legallois (Le Gallois) wrote in his book ‘Expèriences sur le principe de la vie: If the place of the heart could be supplied by injection, and if, for the regular continuance of this injection, there could be furnished a quantity of arterial blood, whether natural, or artificially formed… then life might be indefinitely maintained’.1 This gave birth to the idea of ex vivo organ maintenance. In the course of his experiments, Legallois ligated the inferior vena cava, aorta, carotid arteries and jugular veins in rabbits and ventilated the lungs through a pewter syringe inserted into the trachea of a decapitated rabbit. His landmark observations anticipated the development of the cardiopulmonary bypass pump one and a half century later. But the coagulation system and blood clot formation was an obstacle for a long time. Finally, in 1884, John Berry Haycraft discovered the antithrombotic agent in leech saliva. Jay McLean, an American medical student, discovered heparin in 1916, and it allowed to go one step further. Since the early 1920s, attempts have been made to perfuse isolated animal hearts. Such experiments were conducted by Charles Lindbergh …