Former BAMC commander first to use heart-lung machine in Army

Courtesy Photo | A photograph of the current heart-lung machine being used today.  

FORT SAM HOUSTON, TX, UNITED STATES

02.16.2016

Story by Lori Newman  

Brooke Army Medical Center Public Affairs   

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas – Almost 60 years ago, a young surgical resident at Fitzsimons Army Hospital, Colorado, was assigned a daunting task. He was given three months to learn how to set up and operate a new piece of equipment that would save many lives in the years to come.

Similar equipment was being used at a few medical facilities throughout the U.S., but not at an Army hospital.

Now in his late-80s, former Brooke Army Medical Center commander retired Maj. Gen. Floyd Baker recalls the event as if it happened yesterday. He even has pieces of the original machine and a collection of photographs to document his achievement.

“In 1956, I was the first to set up and run a pump oxygenator in the Army,” Baker said. “We were doing some open heart surgery at Fitzsimons using hypothermia to cool the body down so we could close an atrial septal defect, but we only had four or five minutes to do it.”

An atrial septal defect is a hole in the wall that separates the top two chambers of the heart.

A select few surgeons at the University of Minnesota, Mayo Clinic, Cleveland Clinic and a few other places were beginning to do open heart surgery using a pump-oxygenator machine, the general said.

A pump-oxygenator is a machine through which the blood is temporarily diverted, especially during heart surgery, to oxygenate it and pump it throughout the body. It is also called a heart-lung machine.

“So our boss decided that we needed to do it,” Baker said. “For some reason or another they picked me. I was a first-year surgical resident.”

Baker visited the University of Minnesota and the Mayo Clinic to see what they were doing before spending months in the lab learning how to run the new machine.

“We did the first case on July 27, 1956. Regrettably the patient died, but then the next two lived,” Baker said. “In the beginning, the cardiologists were only giving us patients who were near death, so unfortunately out of the first 15 cases we lost nine of them.”

After the first few cases, Baker realized running the venous blood through the pump didn’t make sense and was causing extra damage to the patient’s blood. They tested the machine again in the lab, doing away with the venous pump and letting the blood run out by gravity.

“Unfortunately we never wrote that up, but that became the standard,” he said.

Baker worked with the machine shop at Fitzsimons to design parts for the pump-oxygenator to make it run more efficiently. He even used his wife’s sewing machine to make a modified filter because the original filter was too harsh on the blood.

“The utilization of cardiopulmonary bypass using a pump-oxygenator machine has expanded dramatically since the early days of cardiac surgery described by Dr. Baker,” said Army Col. (Dr.) Jeffrey McNeil, chief of cardiothoracic surgery at San Antonio Military Medical Center.

In 2013, more than 500,000 cardiac operations were performed with the assistance of cardiopulmonary bypass and more than 100 were performed at SAMMC.

“Like many areas of surgery, the technology has improved dramatically leading to better outcomes. Compared to the high mortality rates in the early days, with modern equipment and techniques, the risk of death with most types of heart surgery is less than 3 percent,” McNeil said.

“Today surgeons are able to perform much more complex operations than was ever envisioned when surgeons began operating on the heart.”

“Military medicine is much better because of pioneers like General Baker,” said Army Col. Evan Renz, BAMC commander. “If brave leaders didn’t take chances we would not have the technologies we have today.”

“All of the capability we have today is possible because of the early heroic work performed by General Baker and others who were pioneers in the development of cardiac surgery,” McNeil added.

Baker received the Army Commendation Medal because of the work he did with the pump-oxygenator.

“Back then junior officers never got awards, and residents never ever got awards -- it was unheard of,” he said. “I am more proud of that Army Commendation Medal than any other award, including the Distinguished Service Medal I received when I retired.”

Baker’s career as a general surgeon in the Army spanned more than 30 years. He was Brooke Army Medical Center commander from 1974 to 1978 and commanding general of U.S. Army Health Services Command at Fort Sam Houston from 1983 to 1986.

“I think I did something that really contributed [to Army medicine],” Baker said proudly.

• Date Taken: 02.16.2016
• Date Posted: 02.16.2016 15:55
• Story ID: 188978
• Location: FORT SAM HOUSTON, TX, US