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It was soon discovered that the repair of intracardiac pathologies was better done with a bloodless and motionless environment which means that the heart should be stopped and drained of blood.The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by Dr.C.Walton Lillehei and Dr.F.John Lewis at the University of Minnesota on September 2,1952.The next year Soviet surgeon Aleksandr Aleksandrovich Vishnevskiy conducted the first cardiac surgery under local anesthesia.

This is a surgery in which the patient chest is opened and surgery is performed on the heart.The term open means to the chest not to the heart itself.The heart may or may not be opened depending on the particular type of surgery.Surgeons realized the limitations of hypothermia complex intracardiac repairs take more time and the patient needs blood flow to the body the patient needs the function of the heart and lungs provided by an artificial method so the term cardiopulmonary bypass.Dr. John Heysham Gibbon at Jefferson Medical School in Philadelphia reported in 1954 the first successful use of extracorporeal circulation by means of an oxygenator but he abandoned the method disappointed by subsequent failures.In 1954 Dr.Lillehei realized a successful series of operations with the controlled cross circulation technique in which the patient's mother or father was used as a heart lung machine.Dr.John W. Kirklin at the Mayo Clinic in Rochester Minnesota started using a Gibbon type pump oxygenator in a series of successful operations and was soon followed by surgeons in various parts of the world.Dr. Nazih Zudhi worked for four years under Drs.Clarence Dennis,Karl Karlson and Charles Fries who built an early pump oxygenator.Zudhi and Fries worked on several designs and re designs of Dennis earlier model from 1952-1956 at the Brooklyn Center.Zuhdi then went to work with Dr.C. Walton Lillehei at the University of Minnesota.Lillehei had designed his own version of a cross circulation machine which came to become known as the DeWall Lillehei heart lung machine.Zudhi worked on perfusion and blood flow trying to solve the problem of air bubbles while bypassing the heart so the heart could be stopped for the operation.Zudhi moved to Oklahoma City so after in 1958 he began working at the Oklahoma University College.Zudhi the heart surgeon teamed up with Dr.Allen Greer a lung surgeon and Dr.John Carey forming a three man open heart surgery team. With the advent of Dr. Zudhi's heart lung machine which was modified in size being much smaller than the DeWall Lillhei heart lung machine and with other modifications reduced the need for blood down to a minimal amount and the cost of the equipment down to $400.00 and also reduced the prep time from two hours to 20 minutes.Dr.Zudhi performed the first Total Intentional Hemodilution open heart surgery on Terry Gene Nix age 7 on February 25,1960, at Mercy Hospital,Oklahoma City,so.The operation was a success however Nix died three years later in 1963.In March,1961 Zudhi,Carey and Greer performed open heart surgery on a child age 3 using the Total Intentional Hemodilution machine with success.That patient is still alive yet.2003