Vivien Thomas developed a novel surgical suture technique for treating cyanotic heart disease
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Historical biographical records document that Vivien Thomas played a major role in developing the Blalock–Thomas–Taussig shunt procedure used to treat cyanotic heart disease in the 1940s.
<h4>Objectives</h4>Palliative treatment of cyanotic congenital heart disease (CCHD) uses systemic-to-pulmonary conduits, often a modified Blalock-Taussig-Thomas shunt (mBTTs). Expanded polytetrafluoroethylene (ePTFE) mBTTs have associated risks for thrombosis and infection. The Human Acellular Vessel (HAV) (Humacyte, Inc) is a decellularized tissue-engineered blood vessel currently in clinical trials in adults for vascular trauma, peripheral artery disease, and end-stage renal disease requiring hemodialysis. In addition to restoring blood flow, the engineered HAV demonstrates the capacity for host cellular remodeling into native-like vasculature. Here we report preclinical evaluation of a small-diameter (3.5 mm) HAV as a mBTTs in a non-human primate model.<h4>Methods</h4>We implanted 3.5 mm HAVs as right subclavian artery to pulmonary artery mBTTs in non-immunosuppressed juvenile rhesus macaques (n = 5). HAV patency, structure, and blood flow were assessed by postoperative imaging from 1 week to 6 months. Histology of HAVs and surrounding tissues was performed.<h4>Results</h4>Surgical procedures were well tolerated, with satisfactory anastomoses, showing feasibility of using the 3.5 mm HAV as a mBTTs. All macaques had some immunological reactivity to the human extracellular matrix, as expected in this xenogeneic model. HAV mBTTs remained patent for up to 6 months in animals, exhibiting mild immunoreactivity. Two macaques displaying more severe immunoreactivity to the human HAV material developed midgraft dilatation without bleeding or rupture. HAV repopulation by host cells expressing smooth muscle and endothelial markers was observed in all animals.<h4>Conclusions</h4>These findings may support use of 3.5 mm HAVs as mBTTs in CCHD and potentially other pediatric vascular indications.
Vivien Theodore Thomas (August 28, 1910 – November 26, 1985) was an American laboratory supervisor who, in the 1940s, played a major role in developing a procedure now called the Blalock–Thomas–Taussig shunt used to treat blue baby syndrome (now known as cyanotic heart disease) along with surgeon Alfred Blalock and cardiologist Helen B. Taussig. He was the assistant to Blalock in Blalock's experim
Vivien Theodore Thomas (August 28, 1910 – November 26, 1985) was an American laboratory supervisor who, in the 1940s, played a major role in developing a procedure now called the Blalock–Thomas–Taussig shunt used to treat blue baby syndrome (now known as cyanotic heart disease) along with surgeon Alfred Blalock and cardiologist Helen B. Taussig. He was the assistant to Blalock in Blalock's experimental animal laboratory at Vanderbilt University in Nashville, Tennessee, and later at Johns Hopkins University in Baltimore, Maryland. Thomas was unique in that he did not have any professional education or experience in a research laboratory; however, he served as supervisor of the surgical laboratories at Johns Hopkins for 35 years. In 1976, Johns Hopkins awarded him an honorary doctorate and named him an Instructor of Surgery for the Johns Hopkins School of Medicine. Without any education past high school, Thomas rose above poverty to become a cardiac surgery pioneer and a teacher of operative techniques to many of the country's most prominent surgeons.
A PBS documentary, Partners of the Heart, was broadcast in 2003 on PBS's American Experience. In the 2004 HBO movie Something the Lord Made, based on Katie McCabe's National Magazine Award–winning Washingtonian article with a similar but longer title, Vivien Thomas was portrayed by Yasiin Bey.
In 1943, while pursuing his shock research, Blalock was approached by pediatric cardiologist Helen Taussig, who was seeking a surgical solution to a complex and fatal four-part heart anomaly called tetralogy of Fallot (also known as blue baby syndrome, although other cardiac anomalies produce blueness, or cyanosis). In infants born with this defect, blood is shunted past the lungs, creating oxygen deprivation and a blue pallor. Having treated many such patients in her work at Johns Hopkins' Harriet Lane Home, Taussig was desperate to find a surgical cure. According to the accounts in Thomas' 1985 autobiography and in a 1967 interview with medical historian Peter Olch, Taussig suggested only that it might be possible to "reconnect the pipes" in some way to increase the level of blood flow to the lungs, but did not suggest how…
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