Dr Ludwig Rehn
Ludwig Rehn, born in Germany on April 13th, 1849, was an innovative figure who rose to become Director of Surgery at the Frankfurt hospital. In the early days of his career, prevailing belief held that heart surgery was an impossibility.
Theodore Billroth, renowned for his contributions to digestive tract surgery, famously stated that any attempt to suture a heart wound would result in loss of respect among peers.
Similarly, Stephen Paget, the English surgeon known for his theories on metastases, asserted in 1896 that the limits of heart surgery were likely set by nature.
A man is on the ground
On September 7th, 1896, a police officer discovered in middle of the night, a drunken 22-year-old man named Wilhelm Justus lying on the ground, wounded. Upon uncovering Justus’s bloody hand covering his chest, the officer noticed a stab wound and promptly took him to Frankfurt City Hospital.
Dr. Ludwig Rehn, the surgeon on duty, found Justus in critical condition with dangerously low bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure.
Acting swiftly, Rehn inserted a metal probe into the chest wound and observed its movement synchronizing with the heartbeat. The situation seemed dire, with little hope of survival without intervention.
The Heart, a Protected Organ
In Justus’s case, the heart, naturally shielded by the sternum and pericardium, faced imminent danger. The term “sternum” derives from the Greek word “sternon,” meaning soldier armor, emphasizing its protective function.
Trapped
Meanwhile, the pericardiumThe pericardium is a sac surrounding the heart and containing a lubricating fluid that allows it to glide with each beat without friction., akin to a thick fibrous pocket, had been pierced by the blade, allowing access to the right ventricle positioned anteriorly to the left ventricle.
This intrusion resulted in the accumulation of bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood, exerting pressure on the heart—a critical condition identified as cardiac tamponade.
First Heart Surgery
In the operating room, Rehn made the decision to open the pericardiumThe pericardium is a sac surrounding the heart and containing a lubricating fluid that allows it to glide with each beat without friction. further, relieving the pressure on the heart.
He then identified a half-inch wound in the right ventricle, from which bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flowed with each heartbeat.
With gentle pressure from his left index finger, he carefully stitches around the wound. Upon completion, he delicately pulls both ends of the thread, ensuring not to exert too much force to prevent damaging the thin wall of the right ventricle.
This action mimics tightening the strings of a purse.
Remarkably, the bleeding ceases as a result —a historic moment marking the first successful cardiac surgery.
And the Honors?
Despite this groundbreaking achievement, Rehn’s report was initially dismissed as anecdotal.
In the field of medicine, recognition often favors those who present their ideas convincingly rather than those who pioneer groundbreaking techniques.
Even today, the medical community remains hesitant to acknowledge Rehn as the true pioneer of cardiac surgery.
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