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Nearly 50 years ago, Bettie Wendt of Spotsylvania County survived experimental |
By ELIZABETH KRIETSCH
On Aug. 14, 1957, 14-year-old Bettie Southworth entered the operating room for a highly experimental medical procedure.
Doctors said the operation had a 50 percent chance of killing her, but she was willing to take the risk because it was her best hope of living a full life.
Her sister, Sandy Pates of Spotsylvania County, remembers saying goodbye to Bettie before the surgery.
"I remember being fearful because I didn't know if I would ever see her again," Pates said.
Once in the operating room, Bettie was given an anesthetic and immersed in a large tub of ice and water, to drop her temperature to 82 degrees.
Surgeons then worked quickly to sew up a half-dollar-size hole in her heart.
The risky surgery took just six minutes, and when the anesthesia wore off, Bettie was alive.
The world of open-heart surgery has drastically changed in the decades since, with improvement of the heart-lung bypass machine and other medical innovations. But at the time, this was a pioneering surgical procedure.
It was so new that the surgery wasn't even available when her heart problem was first detected.
Bettie--who grew up, got married and became Bettie Wendt--was 2 years old when her doctor noticed that the whites in her eyes didn't look right. The doctor suggested she undergo tests, and an examination revealed a heart murmur. That marked the beginning of numerous doctor visits.
Later tests revealed a congenital heart problem called atrial septal defect, meaning she had a hole between the upper two chambers of her heart.
"During my younger years, I went back and forth to the doctors, running tests and such," Wendt said. "But there really wasn't much they could do."
Open-heart surgery didn't exist when she was diagnosed, so there was no treatment available for her then. Her condition, and the lack of options, placed a large amount of stress not only on her, but on her family and doctors.
She recalls being hospitalized on numerous occasions for minor injuries and illnesses because doctors weren't sure how her heart would cope.
"They often put me in the hospital to make sure nothing went wrong," she said.
Eleven years after her diagnosis, Wendt and her family got good news. She had been selected as a subject for an innovative surgical procedure that would repair the hole in her heart.
The surgery would take place at the National Institutes of Health in Bethesda, Md.
The operation would not be without risk--doctors told the Southworths that Bettie had a 50 percent chance of dying during the surgery.
But they also said that her heart would continue to enlarge, and she would probably die in her 20s, if she didn't have the operation.
Her parents allowed her to make the decision, and she chose to go through with the procedure.
Years of being unable to participate in physical activities had begun to wear on her, and she wanted to join the fun.
"I don't really remember being scared," Wendt said, looking back on the surgery.
After she was anesthetized and hypothermia was induced, doctors removed a rib to gain access to her heart. They then tied off the veins to her heart so that no blood would be able to enter. Surgeons quickly stitched the hole shut, and then released the veins to resume normal blood flow to the heart.
The surgery marked the beginning of a new life for Wendt--one with more freedoms, a longer life expectancy and far fewer doctor visits.
It also gave her a new title: In 1958, Wendt was named "Ms. Virginia Heart." She served as a representative and helped raise money for the Virginia Heart Association.
'Almost unheard of'If Wendt were diagnosed with the condition today, the procedure to fix it would be drastically different. In fact, she probably wouldn't need surgery at all.
Cardiologists now treat atrial septal defects through a minimally invasive catheterization technique, according to Phillip Corcoran, cardiothoracic surgeon at the NIH Heart Center at Suburban Hospital in Maryland.
Rather than opening up the heart, doctors perform the procedure by inserting a device into a vein in the groin. They then guide the device up to the hole in the heart, where it is inflated, or "deployed," and then secured to block the hole.
"This procedure is really an advance," Corcoran said of the technique, which was approved by the FDA within the past six to eight years. "If [Wendt] were to be born today, she would never have a surgical incision. Now she could have a permanent safe closure of the heart while avoiding everything else that surgery brings."
The procedure takes one to two hours, and patients are typically able to return home the next day. Wendt remained in the hospital for three weeks.
Corcoran said that open-heart surgery is occasionally still used to treat atrial septal defects in certain situations where the hole is too large to be treated with catheterization. But that doesn't happen very often.
He also noted that advances in fetal ultrasound technology allow for the detection of almost all heart abnormalities before birth. They are usually treated as soon as the child is born.
"Now, a child can't be born in the U.S. without the parents knowing about the hole beforehand," he said. "It is almost unheard of that someone would get to adolescence or the adult years with a hole in the heart."
'Relentless advancement'For the 500,000 heart conditions that do require open-heart surgery each year, much progress has been made over the past 50 years.
"Medicine continues to see a relentless advancement, making heart surgery quite a bit safer than it used to be," Corcoran said.
One of the most significant advances has been in the safety of the heart-lung bypass machine.
Developed by John Gibbon in the '50s, the device temporarily takes over for the heart and lungs, providing artificial circulation in the body. Gibbon first used it on a patient a few years before Wendt's surgery, but the machine was considered complicated, with drawbacks to using it.
The machine improved over the years, and the device now typically involves a series of tubes and roller pumps, which generate blood flow in one direction during surgery.
Another new type of heart-lung machine uses a magnetically driven pump to circulate the blood.
Because of such improvements, surgery for atrial septal defects is now much safer. According to Corcoran, the mortality rate for atrial septal defect surgery is now as low as 0.5 percent, which is shocking in comparison with the 50 percent likelihood of survival Wendt was given when she agreed to be operated on.
Improvements in anesthetic techniques also have contributed to the safety of heart surgery today. In addition, "monitoring techniques are more effective, and medicines are much kinder and gentler to the human heart," Corcoran said.
An active lifeDespite the risks Wendt faced, her operation was completed without complications. Its significance was noted in the Richmond News Leader, in an article that chronicled her condition and the pioneering surgery to fix it.
After a three-week hospital stay, Wendt returned home and began to enjoy the freedoms of living with a healthy heart. She remembers the excitement of being able to participate in physical activities such as bike riding and ice-skating.
"They never allowed me to be active before the surgery," she said. "I was never able to take physical education. But after the surgery, I was told I would be able to do almost anything anybody else did."
She returned to NIH for a few required checkups after the surgery, but no problems were found.
"The surgery went perfectly," she said.
Five years after the surgery, she got married, and she now has two grown children. Doctors were nervous about the toll giving birth would take on her heart, so she was sedated during labor with her first child.
She was scheduled to be sedated for the birth of her second child as well, but she gave birth earlier than expected. Fortunately, her heart was healthy enough to endure labor, and the birth went without complications.
Wendt now works as general business manager at Century 21 Adventure in Spotsylvania. A few years ago, she had bypass surgery for problems unrelated to her heart defect.
At 63, she is healthy and enjoys spending free time with her five grandchildren.
"I go to all of their sports games now," she said. " I'm happy I was able to have the surgery so I am able to enjoy these things."
To reach ELIZABETH KRIETSCH:
Email: ekrietsch@freelancestar.com
