To the Editor:
Several years ago, I published a biographical account of Dr. Frank F. Allbritten, Jr. 1 Dr. Allbritten was an associate of Dr. John H. Gibbon, Jr., in Philadelphia, from 1946 to 1954, and was present during many of Gibbon's early open-heart surgical procedures involving the heart-lung machine. In the article, I credited Dr. Allbritten with devising a left ventricular vent catheter to evacuate the heart of air during open-chambered procedures. New information suggests that credit for this idea rightfully belongs to Dr. Bernard J. Miller (Fig. 1). Like Allbritten, Miller was a research associate of Dr. Gibbon's, and served as a Professor of Surgery at Jefferson Medical College Hospital in Philadelphia from 1950 to 1954. In a personal letter to me dated 24 September 2003, Dr. Miller mentioned that he, Allbritten, and Gibbon had met in 1952 to discuss the subject of decompressing the left side of the heart during experimental repair of atrial septal defects. According to Miller, it was his idea, not Allbritten's, to use a plastic catheter as a low-impedance path for deadly air bubbles to escape. At one point during the discussion, Allbritten did suggest that the catheter be placed via the left atrial appendage. At the time, however, this approach was dismissed in favor of the left ventricular apex. A description of the vent catheter appeared in the literature the following year, with Miller as primary author. 2 Much more recently, at a 1-day symposium, “Gibbon and His Heart-Lung Machine: 50 Years and Beyond” (Philadelphia, May 2003), Miller gave a splendid account of the vent's origin. 3.
Fig. 1 Bernard J. Miller (center), with fellow Philadelphia surgeons Frank F. Allbritten, Jr. (left), and John Y. Templeton III (right), attending a surgical conference in Quebec in 1952.
(From: John Gibbon and His Heart-Lung Machine by Ada Romaine-Davis. Copyright © 1991 Ada Romaine-Davis. Philadelphia: Reprinted with permission of the University of Pennsylvania Press.)
Commercially available vent catheters soon appeared on the market with various individuals and manufacturers taking credit for the idea (Fig. 2). Oscar Wilde once said, “The pure and simple truth is rarely pure and never simple.”. 4 In this instance, however, Dr. Miller's testimony is both accepted and appreciated.
Fig. 2 Advertisement for a left ventricular vent catheter appearing in a 1969 perfusion journal.
(From: Journal of Extra-Corporeal Technology 1969;1(4). Reprinted with permission from the publisher.)
Footnotes
Letters to the Editor should be no longer than 2 double-spaced typewritten pages and should contain no more than 4 references. They should be signed, with the expectation that the letters will be published if appropriate. The right to edit all correspondence in accordance with Journal style is reserved by the editors.
References
- 1.A tribute to Frank F. Allbritten, Jr.: Origin of the left ventricular vent during the early years of open-heart surgery with the Gibbon heart-lung machine. Tex Heart Inst J 2001;28:292–6. [PMC free article] [PubMed]
- 2.Miller BJ, Gibbon JH Jr, Greco VF, Cohn CH, Allbritten FF Jr. The use of a vent for the left ventricle as a means of avoiding air embolism to the systemic circulation during open cardiotomy with the maintenance of the cardiorespiratory function of animals by a pump oxygenator. Surg Forum 1953;4:29–33. [PubMed]
- 3.Miller BJ. Laboratory work preceding the first clinical application of cardiopulmonary bypass. Ann Thorac Surg 2003; 76:S2203-9. [DOI] [PubMed]
- 4.Winokur J, editor. The portable curmudgeon. New York: New American Library; 1987. p. 272.