Celebrating advancements of cardiac care               

Sixty-five years after her open-heart surgery — a procedure that was pioneered in the U.S. just years before she needed it — Andree Jacob's heart is still ticking strong. She is a living testament to the importance of medical innovation and the lifetime of gratitude that comes with it.

When Andree, 72, from the Canadian province of Quebec, was a child, her mother noticed she caught colds easily and withdrew to rest often while playing. Her heart would beat rapidly, visible even through her clothes.

Concerned, her mother took her to the doctor multiple times and insisted on testing until a medical team in Montreal discovered Andree had atrial septal defect (ASD). This heart condition, a hole between the upper heart chambers, allows an increased amount of blood through the lungs. This defect may cause shortness of breath; tiredness; swelling of the legs, feet or belly area; and irregular heartbeats, skipped heartbeats, or feelings of a quick, pounding or fluttering heartbeat.

The surgery that saved Andree's life

In the fall of 1958, Andree was scheduled for heart surgery in Montreal, but the operation was postponed. Her father's cousin, Dr. Camille Dufault, an internist involved in research in Canada, arranged for her to have surgery at the renowned Mayo Clinic.

In May 1959, at 7 years old, Andree and her father traveled to Rochester, Minnesota, for surgery.

"I remember the surgery day vividly. My father left me in the care of two nuns before the operation, and I felt abandoned when he didn't follow me into the operating room. I only spoke French at the time," recalls Andree.

Andree's father, a farmer, wrote letters to her mother for the 28 days Andree stayed at Mayo Clinic. He reassured his wife that Andree was doing well, while also reminding her to tend to the dairy cows, pigs and chickens.

A life full of gratitude and resilience

Returning home in June 1959, Andree resumed life with a new vigor. She grew into an active adult who married her American husband in 1974. Together they built a beautiful life with their two daughters and their families. Other than a more recent medication for heart palpitations, her heart has remained healthy and strong.

"On this year's heart anniversary, the number 65 resonated deeply with me, reminding me of how far I've come and how fortunate I am," she recalls. "The courage my parents showed in pursuing the best possible care for me is something I will always honor. They placed their faith in a medical team across the border."

"I am overwhelmed by gratitude — for the skilled hands of the surgeons at Mayo Clinic, for my parents' unwavering support and for the beautiful life I have lived since. Every year, we reflect on the miracles and the love that have shaped our lives," she continues.

History of cardiac innovation

In the 1950s — the time of Andree's surgery — cardiac surgery was still developing. Dr. John W. Kirklin, the Mayo Clinic surgeon who performed Andree's life-changing surgery, was a pioneer in modern-day cardiac care. As a young surgeon supported by a multidisciplinary team of physicians and technicians in Rochester, Dr. Kirklin envisioned using a mechanical pump-oxygenator to support the circulation while working inside the heart.

Dr. Kirklin’s persistence paid off in 1955 with the first successful use of the heart-lung machine at Mayo Clinic.

"The only way to address structural abnormalities inside the heart, like ASD, was to stop the heart so you could go inside it. We needed a heart-lung machine to support the patient's bodily systems," says Dr. Joseph Dearani, cardiovascular surgeon at Mayo Clinic. "It was a revolution and paved the way for the whole future of cardiac surgery."

A flutter of innovation

The first 50 years of cardiac surgery were marked by the introduction of new procedures, especially for congenital heart disease.

The next 50 years have brought many significant advances in cardiology and cardiac surgery:

• Heart-lung machines with numerous safeguards and alarms to address issues immediately during surgery.
• Cardiac catheterization labs (cath labs) with technology that allows doctors to access the heart through a peripheral vessel or another vein, avoiding open-heart surgery and enabling same-day discharge.
• Sophisticated imaging techniques like echocardiography, CT scans and MRI that provide detailed road maps for surgery, allowing surgeons to create 3D models and practice operations on rare anomalies before entering the operating room.
• Advanced anesthesia techniques that enable many patients to have their breathing tubes removed immediately after surgery, along with improved pain management protocols aimed at "painless heart surgery."
• Robotic heart surgery, minimally invasive surgery and thoracoscopic surgery that use small incisions and cameras, resulting in shorter hospital stays, reduced pain and quicker recovery.
• Advanced medications administered around the time of surgery to stabilize patients during the procedure and promote faster recovery.
• More aggressive care plans that encourage patients to walk the halls with rehabilitation staff shortly after surgery, enhancing healing and enabling remarkable activity even the day after surgery.
• Improved understanding of technologies that help experts enhance patient tolerance to surgery and speed recovery.

"So many of the surgeries that we used to perform wouldn't require surgery now because we can treat the patients noninvasively in the cath lab," says Dr. Jonathan Johnson, pediatric cardiologist and chair of the Division of Pediatric Cardiology at Mayo Clinic. "Now we routinely replace valves, insert stents — things that once required opening the chest. Many of those patients don't even have to stay overnight in the hospital."

What's next: Transforming cardiac care

As healthcare continues to evolve at an unprecedented rate, Mayo Clinic continues searching for ways to transform healthcare with artificial intelligence (AI), genetic screening and virtual tools.

• Artificial intelligence: In the future, AI will transform how heart defects are detected and diagnosed from birth. AI will be integrated into handheld ultrasound devices and ECGs to help doctors and care teams record the heart's electrical activity more effectively across different healthcare settings and improve their accuracy. This means that signs of heart issues could be spotted much earlier, even when they're not obvious. AI also will support experts by picking up small irregularities on ECG that might suggest more complicated heart conditions, helping doctors better understand and treat heart issues early on.
• Genetic screening: New genetic screening technologies will become a vital tool. Healthcare professionals will use genetic information to predict the risk of developing heart defects, providing crucial insights even before any symptoms appear. Collaborations with genetic researchers will refine these screenings, making them more accurate and helpful for predicting and managing heart health from earlier ages.
• Advancement in cardiac surgery: Cardiac surgery is increasingly adopting more objective methods to assess and improve performance, focusing on communication and technical skills in the operating room. For example, Mayo Clinic, the University of Michigan, the University of Edinburgh in the U.K., and the United States Tennis Association recently received National Institutes of Health funding to use advanced video assessment techniques to analyze surgical skills in the operating room. This approach will allow surgeons to review their procedures alongside experienced colleagues, providing clearer insights into areas for improvement.

Some things never change

Despite decades of medical innovation, the heart behind pediatric cardiac care at Mayo Clinic beats as strong as ever.

"Our team of professionals work together to do the best for each child’s situation," reflects Dr. Johnson. "It's a ballet of people working together at the same time to create this amazing performance. It's extremely humbling to be part of a field that saves and improves lives. Every day, this remarkable team has nothing but their patients on their minds — that's an incredible thing."

Andree couldn't agree more. "My story is not just about survival," she says. "It's about the extraordinary strength of family, the advancements in medicine and the kindness of those who care for others. It's a reminder that every day is a gift."

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