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BIGELOW LECTURE

Going Green

Wilfred Bigelow
Wilfred Bigelow

Wilfred Gordon Bigelow was a pioneering cardiac surgeon who chaired the Division of Cardiac Surgery from 1956 to 1977. Dr. Bigelow’s special contribution to surgery of the heart was the use of hypothermia to slow tissue metabolism and thus protect the heart and brain from damage. He began this work with tedious, but indispensable animal trials and by 1952 he was ready to apply this procedure to patients. At Toronto, the hypothermia research program led to another equally important breakthrough for cardiac surgery - the development of the first implantable cardiac pacemaker.

(adapted from Cold Hearts by Gunnar Staalesen, Arcadia Books, 2013)

The 2016 Bigeow Lecturer, Joseph Woo serves as the Norman E. Shumway Professor and Chair of the Department of Cardiothoracic Surgery at the Stanford University School of Medicine. He received his undergraduate degree from the Massachusetts Institute of Technology and his M.D. from the University of Pennsylvania where he also obtained his postgraduate surgical training. At Penn, Dr. Woo also completed a postdoctoral research fellowship in novel molecular strategies for attenuating myocardial ischemic injury for which he won the American Heart Association Vivien Thomas Young Investigator Award. Dr. Woo joined the Penn faculty in 2002 as the Director of the Minimally Invasive Cardiac Surgery Program. He helped to advance the field of complex valve repair and developed several innovative new mitral and aortic valve operations. He also led the Mechanical Circulatory Assist and Cardiac Transplant Program and has likewise developed novel LVAD and transplant techniques. Dr. Woo built a robust practice, performing 350-400 pump cases per year and was listed in the Philadelphia Magazine as one of the region’s Top Doctors for several consecutive years. In 2014, Dr. Woo moved to Stanford University to lead the Department of Cardiothoracic Surgery. Under his leadership, overall cardiovascular surgical clinical volume, extramural research funding, and residency education programs in the Department have grown significantly.

Christopher Caldarone with Joseph Woo and James Rutka

Christopher Caldarone with Joseph Woo and James Rutka

Dr. Woo currently runs an NIH R01-funded basic science research lab studying stem cells, angiogenesis, and tissue engineering. He is an Associate Editor for the Journal of Thoracic and Cardiovascular Surgery and has served as a Guest Editor for Circulation.

Honoring the legacy of Bill Bigelow, Dr Woo presented an illustrated northern constellation of cardiothoracic surgical stars trained in Toronto, followed by a southern constellation of surgeons trained by Norman Shumway at Stanford. He told us how Shumway, following the lead of Bigelow in studying hypothermia, included excision and re-implantation after cold immersion of the heart- this led to his realization of the feasibility of orthotopic cardiac transplantation, for which he became the world’s leader.

Woo’s Bigelow lecture entitled “Are Surgeons Going Green? The Quest for Reconstruction and Renewables” focused on a series of remarkable advances in the program at Stanford: doubling of the cardiac surgical volume, 99% repairs rather than replacements for mitral valve disease, minimal access valve repairs, even on the beating heart. In an echo of the Keshavjee lab’s ex vivo resurrection of unsuitable donor lungs for transplantation, the Stanford surgeons perform ex vivo valve repairs on donor hearts otherwise considered unsuitable- before transplanting them. The Stanford surgeons performed 67 heart transplants in 2015.

Christopher Caldarone with Ian Currie, Joseph Woo and Pixie Bigelow Currie

Christopher Caldarone with Ian Currie, Joseph Woo and Pixie Bigelow Currie

Domino Transplants of the heart and lungs, minimal access implantation of a tiny intra-cardiac left ventricular assist device, studies of cardiac regeneration using stem cells, endoscopic harvest of the radial artery and construction of multi-pedicled arterial coronary grafts without touching the aorta were described as part of the Stanford clinical program. From the laboratory, the cytokine cyclin for regeneration and primordial bacterial chloroplast enhancement for oxygenation studies took us to the leading edge of cardiac surgical research.

Members of the Bigelow family in attendance, Joseph Woo and host Christopher Caldarone are pictured nearby celebrating a lecture that would delight Bill Bigelow

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