Episode 2- Dr ELLIOT CUTLER

26 November 2017

Episode 2- Dr ELLIOT CUTLER

 

 

Elliot Cutler was a surgeon. He was born in the United States on July 30th, 1888.

Considered as a pioneer at Harvard University in Boston, he ended his career within the American army with the rank of brigadier general.

After the First World War, he planned to treat the narrowing of the mitral valve by surgery (called mitral stenosis). Mitral stenosis is a progressive narrowing of the mitral valve that occurs following rheumatic fever.

His plan was to access the mitral valve through a small incision at the bottom of the left atrium and then create an incision in one of the diseased leaflets of the mitral valve.

In 1923, he performed the first cardiac valvular surgery successfully.

It was a 12 years old girl who developed mitral stenosis after she had rheumatic fever. The description of this first surgery was published in the British Medical Journal.

The glorious period was not very long. Only one of the seven patients operated by Dr. Cutler survived.

This high mortality rate was caused by of a more serious problem created while trying to correct the first one…

While making an incision into the narrowed mitral valve to improve blood flow from the left atrium to the left ventricle, the valve became incompetent and inefficient.  The incision generated an important leak and blood regurgitation into the left atrium.  The heart was unable to support this acute mitral insufficiency.

Surgery for mitral stenosis consequently was abandoned in 1928.

We had to wait until 1945 to see another intrepid physician attempting mitral valve repair.

An ironic say about medical research in those days was that we learn more from our failures than from our success, that we learn more from the unforeseen results than from those anticipated…

 

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