Historical Perspective On Perfusion - News Story Reprinted

Open heart patient looks back

Toledoan underwent surgery in 1959

By JULIE M. McKINNON BLADE STAFF WRITER
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Sandra Katschke has had a heart murmur for more than 50 years.

Still, that defect is far better than the likely alternative for the 62-year-old Toledoan, the first locally to have open heart surgery using a heart-lung machine.

Without the November, 1959, surgery purportedly to widen her pulmonary valve, the then-12-year-old Sandra Schermbeck probably would never marry and have children, one of her doctors said.

"He told me I wouldn't live to be 21," Mrs. Katschke recalled. "I'm doing really well."

At age 12.At age 16 with Mother.



Dr. Michael Moront, a Toledo cardiac surgeon who met Mrs. Katschke last week after learning of her story, said she probably needed the area above the valve widened, not the valve itself, because it wouldn't have lasted this long if it was congenitally defective. Dr. Moront listened to Mrs. Katschke's heart last week and noted the murmur, and he termed the grandmother's longevity, especially without further surgery, "miraculous."

"Today, most people would say you would require more surgeries," Dr. Moront said. "They did a remarkable job for you."

Much has changed in cardiac surgery since Mrs. Katschke was operated on at Toledo Hospital by a team of 14, including several doctors. A couple dozen more doctors observed the novel surgery, for which a heart-lung machine was used to mechanically circulate and oxygenate blood so work could be done on her heart.

"It was very exciting stuff back in the '50s, and it still is today," Dr. Moront said while showing Mrs. Katschke and her husband of 40 years, Ed Katschke, a heart-lung machine currently used at Toledo Hospital.

Heart-lung machines, first successfully used in Philadelphia in 1953, are one aspect of cardiac surgery that has changed since the specialty was in its infancy and Mrs. Katschke underwent surgery.

Before heart-lung machines, some surgeries were performed by connecting a child to a parent, who kept blood flowing, Dr. Moront said. "The adult would serve as a heart-lung machine for a child," he said.

Oxygenating blood was the trickiest function with heart-lung machines in those days, and improvements have been made through the decades, said former perfusionist Terry Kirch of Northwood, who started working at Toledo Hospital in 1968. A perfusionist is a medical technician responsible for blood transfusion and the heart-lung machine during cardiopulmonary surgery.

Originally, patients could be on heart-lung machines for only minutes; now they can be on for days, Mr. Kirch said. Plus, heart-lung machines were primed with donated blood until the early 1970s, when a solution started to be used, he said.

"That, I think, is one of the biggest advances we had," said Mr. Kirch, who was one of the first 75 people nationwide certified as perfusionists.

Mrs. Katschke's grandparents, the late Marie and Warren Lincoln, who were her guardians, had to locate 30 volunteers to donate A-positive blood for her surgery. Volunteers included seven inmates from the county jail.

Preparing the heart-lung machine and donated blood for Mrs. Katschke's surgery probably took several hours, said Kevin Fleming, a Toledo Hospital perfusionist who explained last week to the Katschkes how the machine works.

"Back then, it would take about as long to prepare the case as it did to do the case," he said.
Mrs. Katschke, who prior to surgery was often sick, missed a lot of school, and was unable to play, returned to school after holiday break.

She remembers being afraid of surgery.

"There was one little boy who passed away before my surgery, and I was scared to death," she said of a fellow patient with a different heart problem.

An intensive-care unit to closely monitor patients was not used when Mrs. Katschke had surgery. Some medications used then still are around today, including epinephrine, but there have been many pharmaceutical advances since, Dr. Moront said.

There also have been a slew of advances in surgical techniques and equipment, he said. Three-dimensional ultrasounds, for example, give surgeons exact images.

Although Mrs. Katschke has had other health problems since her 1959 open heart surgery, she has not had cardiac issues.

The mother of three doesn't take heart medication either, although she does tire easily and regularly sees a cardiologist, she said.

"I still have trouble if I'm walking a long distance," Mrs. Katschke said. "I get out of breath. Other than that, I do fine."

Contact Julie M. McKinnon at: jmckinnon@theblade.com or 419-724-6087.