History of Vascular Cardiovascular Surgery in Cuba
Although there are references that during the year 1941, at the Municipal Children's Hospital of Havana, Dr. Manuel Carbonell Salazar, with the anesthetic help of Dr. Mesa Quiñones, operated two children who were closed by the Persistence of Ductus Arterious, it is considered that cardiovascular surgery took its first steps in Cuba when in 1951 the Institute of Cardiovascular and Thoracic Surgery was founded in the Orthopedic Hospital of Avenida de los Presidentes and 29th Street, in Havana, (now Fructuoso Rodríguez).
From then on, the so-called "closed" cardiovascular operations began, without the need for a heart-lung machine or extracorporeal circulation (ECC), a device that replaces the functions of the heart and lungs during the surgical procedure.
By that time, the world still did not have such equipment that not even Jules Verne imagined. Indeed, it was on May 6, 1953 that John Gibbon successfully completed the work of his life, closing for the first time, with the help of a heart-lung machine of his invention, an atrial septal defect in a young woman .
In the Institute of Cardiovascular and Thoracic Surgery, founded by the distinguished surgeons, doctors Antonio Rodríguez Díaz and Hilario Anido Fraguedo, with the acquisition in 1956 of a CEC machine, known as the "Lillehei pump", they started cardiac heart surgery opened with the anesthesiological help of doctors Francisco Gutiérrez Peláez and Servando Fernández Rebull. From that date until 1960 they carried out more than six hundred open and closed operations, making our country one of the first four in the world (United States, Cuba, Sweden and France) that at that time developed heart surgery and of big glasses.
Simultaneously, at the Municipal Children's Hospital (Pedro Borrás), Dr. Angel Giralt operated more than 400 children affected by congenital heart disease, taxed by closed-heart surgical corrections, that is, without the need for extracorporeal circulation, which were diagnosed with angiography. Cardiography at the Cardiology Foundation, which worked under the aegis of Drs. Agustín Castellanos and Otto García Díaz.
In turn, at the Arturo Aballí Children's Hospital, Dr. Rogelio Barata Rivero, with the anesthetic help of Dr. Pedro Jiménez, carried out numerous closed and open heart surgeries counting on the "Lillehei Pump", operated by his nephew. they all called "Baratica".
Meanwhile, at the General Calixto García University Hospital, Dr. Roberto Guerra performed some closed operations and Dr. Antero Sánchez openly at the Arturo Aballí Hospital with the help of Dr. Noel González Jiménez who had done an internship in Minneapolis with the Dr. Walton Lillehei.
Most of these operations were carried out free of charge by the medical teams but with the material resources that were purchased by the patients and relatives in the style of the time; Operations were also performed in some private clinics. The Institute of Cardiovascular and Thoracic Surgery was supported by a patronage of Havana philanthropists.
Between 1960 and 1962, the doctors who formed the surgical teams left the country and cardiovascular surgery was interrupted until 1961, when the Ministry of Public Health under the direction of Dr. José Machado Ventura, in view of the need created, held Dr. Noel González Jiménez, who had worked with Dr. Antero Sánchez, with the task of forming a cardiovascular surgery team at the Comandante Manuel Fajardo Hospital where Dr. Roberto Guerra was Head of the Department of General Surgery and where the machines and other equipment for extracorporeal circulation of the Institute and of other hospitals.
Dr. Noel González Jiménez began in 1961 the training of the team performing operations on animals with the help of young surgeons. In that group participated Dr. Julio Tain Blázquez who would eventually succeed him and Pedro Kilidjian Dejjian and the anesthesiologists Dr. Samuel Yelín Gringros and Gilberto Gil Ramos who also operated the CEC machines.
With the collaboration of Dr. Castro Villagrana of the Cardiology Institute of Mexico, previously trained in Houston; in 1966, open-heart surgery with extracorporeal circulation was started in humans for the treatment of congenital heart defects and valvular malformations; until then some operations on intracardiac defects were operated with surface hypothermia techniques.
Since 1960 in several hospitals of the Capital were carried out "closed" operations, particularly the Mitral Commission for eminent surgeons and anesthesiologists of the time "where Dr. Guillermo Hernández Amador and Díaz Arrastía stood out with Samuel Yelín and Israel Pérez in the Hospital Pediatric William Soler; Eugenio Torroella Martínez Fortún, Emilio Camayd Zogbe and Alberto Porro de Zayas at the National Hospital and Dr. José Cambó Viñas at the Joaquín Albarrán Surgical Clinical Hospital.
Consolidated the performance of open heart surgery in the already created Institute of Cardiovascular Surgery (1966), its surgical facilities went from Section C of the Radium Institute to the 4th. Floor of the Hospital Cmdte. Manuel Fajardo; but evidently they were totally insufficient for the purposes of research, training of specialists and perioperative assistance to cardiologists.
Attentive to this urgent need for a property that would achieve those goals, the Ministry of Public Health decided to provide the nascent Institute with the facilities offered by a modern, well-designed clinic located in El Vedado, which, from February 1969, was constituted the Institute of Cardiovascular Surgery directed by Dr. Noel González Jiménez and where its founders were Julio Tain Blázquez, Felipe Rodiles Aldana, Manuel Jacas Tornés and José Arango Casado as Surgeons; Doctors Hilario Cortina Alonso, Humberto Saínz Cabrera and Gilberto Gil Ramos as Resuscitation Anesthesiologists and Perfusionist and Drs. Florencio Gamio Capestany, Joaquín Bueno Leza and Mireya Amoedo Mon as cardiologists and Dr. Rolando Pereira Costa as Radiologist; supported by a small group of nurses: Miss. Luisa Jiménez, Enma Martí, Carmen Rosa Agüero, Amparo González, Amparo Rodríguez, Oralia García, Marta Corpión, Nora Mollinedo, Amanda and Yolanda de la Fuente plus the technicians of Laboratory and Transfusions: Omayra García, Carlos Cabrera and Francisco Sánchez
It is in this year of 1969 in which, as a need for the resuscitation of the critical condition of the open-heart operated patient, the ICCCV was created that in the history of Cuban medicine is recognized as the first Care Unit in which applied the concepts and rigors of intensive medicine, the UCIQ.
During the second half of the decade of the 70s and attending to the political will of the Government, the Institute undertook the training of all the medical and technical personnel that would later found the Cardiocentros of Santa Clara, Santiago de Cuba and the Pediatric from the William Soler Hospital in Havana, which gradually opened its doors in the 80s, becoming in fact the ICCCV in the "Alma Mater" of the Cuban Cardiovascular Surgery.
There are currently six Cardiocenters in the country, three for adults: Institute of Cardiology and Cardiovascular Surgery, Hermanos Ameijeiras Hospital and CIMEQ; two mixed in which children older than three years and adults are operated in Villa Clara and Santiago de Cuba and the William Soler Hospital, specialized in the treatment of congenital and acquired heart diseases in children of all ages up to 18 years of age. Annually more than one thousand five hundred cardiovascular operations are carried out in our country
The Institute of Cardiology and Cardiovascular Surgery with its 50 years of existence has developed an extensive work in favor of maintaining the quality of life of its patients, has seven working groups that are Cardiovascular Surgery, Ischemic Cardiopathy, Arithmology, Rehabilitation, Preventive Cardiology Investigation and development; as well as laboratories of Chemistry, Hematology, Biochemistry, Microbiology, Radiology, Echocardiogram and Nuclear Medicine.
Among the services offered by the Institute of Cardiology are:
Where aortic valve, tricuspid mitral valve, surgical myocardial revascularization for congenital defects, valve replacement, left ventricular remodeling, surgical closure of atrial septal defect (AIC), ventricular defect (VSD), coarctation of the aorta, patent ductus arteriosus ( PCA), ascending aortic aneurysm + aortic insufficiency, ruptured valsalva sinus (AD-VD) and aortic dissections.
Coronary angiography, percutaneous coronary intervention (coronary angioplasty) and peripheral (renal and inferior limbs peripheral angioplasty), mitral and pulmonary valvuplasty, Coartoplasty.
Arrhythmia and pacemakers:
Implantation of unicameral and bicameral pacemaker, electrophysiological study, radiofrequency ablation of accessory pathways, intranodal tachycardia, atrial flutter, implantation of automatic defibrillator (unicameral-bicameral DAI) in malignant ventricular arrhythmia, ventricular resynchronization therapy with multisite stimulation in refractory heart failure , combined therapy of severe ventricular dysfunction and malignant ventricular arrhythmia with implantation of DAI + resynchronization.
Cardiovascular rehabilitation:Diagnostic and evaluative stress tests are developed, ergospirometry, functional and respiratory tests, ambulatory monitoring (holter) of blood pressure and arrhythmias, late potentials, smoking cessation program, evaluation and treatment of obesity, prevention program of the ischemic cardiopathy and rehabilitation with physical exercises after cardiac infarction or cardiovascular surgery, attention to sexual dysfunction in heart disease, as well as psychological intervention program in patients with heart disease.
At present there are five other Cardiocentros located in the Hermanos Almeijeiras Hospital, the CIMEQ, the Willian Solar Hospital and in the provinces of Villa Clara and Santiago de Cuba.