Title: The Early Days of Cardiac Surgery in South Asia: The History and Heritage
Abstract: The 1.79 billion people of South Asia share common history and heritage. The fascinating stories of introducing cardiac surgery in this region would inspire the surgeons today. Information was collected for more than a decade from these countries through personal visits, interviews, and searching journals and the Internet. India was first to establish cardiac surgery chronologically, followed by Sri Lanka, Pakistan, Bangladesh, Nepal, and Afghanistan. South Asia did not lag far behind the Western world in commencing cardiac surgery. The pioneering surgeons deserve respect for their dedication and innovation overcoming the economic hardship and bureaucratic barriers ensuring service for one-quarter of the world's population today. The 1.79 billion people of South Asia share common history and heritage. The fascinating stories of introducing cardiac surgery in this region would inspire the surgeons today. Information was collected for more than a decade from these countries through personal visits, interviews, and searching journals and the Internet. India was first to establish cardiac surgery chronologically, followed by Sri Lanka, Pakistan, Bangladesh, Nepal, and Afghanistan. South Asia did not lag far behind the Western world in commencing cardiac surgery. The pioneering surgeons deserve respect for their dedication and innovation overcoming the economic hardship and bureaucratic barriers ensuring service for one-quarter of the world's population today. South Asia is the geographic region occupying the south central part of the Asian continent. Bounded by the mountainous ranges of the Himalayas and the Hindu Kush in the north and by the three confluent marine entities in the south, explicitly the Bay of Bengal, the Arabian Sea, and the Indian Ocean, this area is a land of diverse geography. The 8 countries of the region, Afghanistan, Bangladesh, Bhutan, India, Nepal, the Maldives, Pakistan, and Sri Lanka together have an area of 1.9 million square miles (5.1 million square kilometers). The combined population of these countries in 2015 was approximately 1.79 billion or more than 23% of the world population. These figures make the region the most populated and also the most densely populated region of the world. The people of South Asia share common historic, cultural, ethnic, and linguistic heritage. From 1526 until 1947, most of this vast area was ruled by two of the greatest dynasties of human history, first the mighty Mughals and then the British monarchs. These four centuries of central authority reigning blended the 1.8 billion diverse inhabitants of the region to bestow a unique identity. The modern health care system in the region was introduced during the British regal era. They had built Western-style health care facilities in the major urban centers, which were later expanded in the distant localities after end of the colonial rule. Each country maintained its own health care system and updated with the worldwide changes. However, as one of most difficult and sophisticated branches of medical science, the growth of cardiac surgery has not been easy. As of 2016, 6 countries of the region, save tiny Bhutan and the Maldives, have their own established cardiac surgical programs. These countries have unique stories portraying how cardiac surgery began there. My objective here is to depict those interesting pieces of historic heritage for the surgeons of today. The sacrifice, dedication, and innovation of these ancestors would inspire the successors. Moreover, there are some important links in the history of cardiac surgical development in these nations. Exploring these links and publishing the pen picture of those golden days of different countries under same heading would inspire the sense of brotherhood and collaboration among the cardiac surgeons. The countries of south Asia are trying to build up cooperation with each other. There is similarity of disease pattern in South Asian patients, which is often quite different from that of the Western world. Working together for treatment and research would be beneficial for the South Asian people. The stories of the past thus would help build the future, ultimately benefiting one-quarter of the World population. Collecting information from 8 different countries and compiling those was quite a difficult task. With a view to fulfilling the passion for history and heritage of cardiac surgery, I have been working on the topic for more than a decade. I made several personal visits to many cardiac surgical centers in 6 of these countries in search of interesting pieces of first-hand information. Senior surgeons, anesthetists, and cardiologists were interviewed and contacted for accurate stories whenever possible. In some of the countries, the pioneers are still alive and were available for interview, whereas in others, the next generations became the source of information. The national societies were approached in search of information. Thorough Web exploration was undertaken using Internet search engines. All of the information collected from various sources was verified, crosschecked, and then compiled in the form of this article. Some lucrative photographs could not be used because of copyright issues. Some interesting information could not be cited for lack of an established reference. Writing the history of such diverse nature is a difficult job, and despite my maximum effort to ensure authenticity of information, there may be some disagreement on a few issues. But if others are inspired to come forward in similar research to contribute, that would be the success of this endeavor. India is the largest country of South Asia in area and population and was also the first country to establish cardiac surgery in the region. The first reported successful cardiac operation was repair of an left ventricular stab wound performed by Dr K.M. Shah, a surgical registrar at the King Edward Memorial Hospital, Bombay, in 1946 [1Naidu K.V. Presidential Address. 50 years of cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 1996; 12: 1-6Crossref Google Scholar]. A few months later in 1947, his senior colleague in the same department, Dr A.V. Baliga, performed a pericardial drainage to relieve the cardiac tamponade of a patient. Dr B.R. Billimonia performed the first patent ductus arteriosus ligation at Masina Hospital, Bombay, in 1949 [2Saxena A. The history of pediatric cardiology in India.J Pract Cardiovasc Sci. 2015; 1: 203-205Crossref Google Scholar]. The first cardiothoracic surgery department of this region was established at the Christian Medical College, Vellore, in 1948 by Dr Reeve Hawkins Betts, a missionary surgeon from the United States [3Gopinath N. Development of cardiovascular and thoracic surgery in India—golden era.Indian J Thorac Cardiovasc Surg. 2004; 20: S16-S19Crossref Scopus (2) Google Scholar]. He was a World War II veteran with immense experience of managing wartime chest injuries while serving in the African theaters [4Padmavati S. Development of cardiothoracic surgery in India.Indian J Thorac Cardiovasc Surg. 2004; 20: S50-S52Crossref Scopus (3) Google Scholar]. After the war, he opted for voluntary services in India for 12 years, defying many prestigious and lucrative offers in the United States [5Stanley J. Cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 2004; 20: S20-S23Crossref Scopus (3) Google Scholar]. He remained in India until 1960 and trained some of the first-generation Indian cardiothoracic surgeons, including T. Thomas and M. Gopinath. Betts performed a patent ductus arteriosus closure on March 2, 1950, and then the first Potts-Smith shunt in a patient with tetralogy of Fallot on February 27, 1951, at Vellore [3Gopinath N. Development of cardiovascular and thoracic surgery in India—golden era.Indian J Thorac Cardiovasc Surg. 2004; 20: S16-S19Crossref Scopus (2) Google Scholar]. A brilliant thinking innovative Bengali surgeon Dr Parfulla Kumar Sen, popularly known as P.K. Sen, revolutionized the cardiac surgery scenario of India in the 1950s. He performed the first real intracardiac procedure, a digital closed mitral valvotomy at King Edward Memorial Hospital in 1952. Using an otolaryngology nasal polyp removal snare and replacing the wire with a braided silk for controlling the entry of the index finger inside left atrial appendage, he opened the stenosed mitral valve [1Naidu K.V. Presidential Address. 50 years of cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 1996; 12: 1-6Crossref Google Scholar]. By 1955 it was established as a regular procedure at King Edward Memorial [6Parulkar G.B. Developments in cardiovascular surgery in India during last five decades.Indian J Thorac Cardiovasc Surg. 2004; 20: S24-S30Crossref Scopus (5) Google Scholar]. In 1953 Dr P.K. Sen performed the first repair of coarctation of aorta. He also closed the first atrial septal defect (ASD) using surface hypothermia and inflow occlusion technique in 1956 [1Naidu K.V. Presidential Address. 50 years of cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 1996; 12: 1-6Crossref Google Scholar, 6Parulkar G.B. Developments in cardiovascular surgery in India during last five decades.Indian J Thorac Cardiovasc Surg. 2004; 20: S24-S30Crossref Scopus (5) Google Scholar]. The first ASD closure at Vellore was done using surface hypothermia on December 21, 1957, and the first coarctation of aorta was performed on November 7, 1956 [3Gopinath N. Development of cardiovascular and thoracic surgery in India—golden era.Indian J Thorac Cardiovasc Surg. 2004; 20: S16-S19Crossref Scopus (2) Google Scholar]. Dr A.K. Basu, of Presidency General Hospital, Calcutta, performed an aortic valvotomy using the inflow occlusion technique in 1959 [7Das M.K. Kumar S. Deb P.K. Mishra S. History of cardiology in India.Indian Heart J. 2015; 67: 163-169Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar]. Christian Medical College, Vellore, became the first institution in South Asia to introduce a specialized course in thoracic surgery. In March 1960, 3 candidates of Christian Medical College, Vellore, appeared in the Master of Surgery (Thoracic Surgery) examination at the University of Madras [5Stanley J. Cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 2004; 20: S20-S23Crossref Scopus (3) Google Scholar]. Dr Gopinath passed and became the first certified thoracic surgeon of this region. The cardiopulmonary bypass era of India began in 1961. Dr Kersi Nusserwanji Dastur, of BYL Nair Hospital, Bombay, was the pioneer in this regard [8Kalke B.R. Magotra R.A. Tribute to Kersi Dastur, a pioneer in open heart surgery in India.Indian J Thorac Cardiovasc Surg. 2010; 26: 228-232Crossref Scopus (3) Google Scholar]. He worked with a team of medical and engineering associates to manufacture his own model of a heart-lung machine. Lack of research funding, bureaucratic barriers, and strict import rules made things really difficult. After years of hard work in factories and animal laboratories, financed by the income from his own private practice, the dogged perseverance of Dr Dastur and his associates ultimately paid off through creating their locally improvised heart-lung machine. Dr Dastur and his surgical team (Fig 1A ) finally closed an ASD of a 19-year-old girl at Nair Hospital, Bombay, on February 16, 1961, using cardiopulmonary bypass with his locally improvised heart-lung machine (Fig 1B) and oxygenator (Fig 1C) [8Kalke B.R. Magotra R.A. Tribute to Kersi Dastur, a pioneer in open heart surgery in India.Indian J Thorac Cardiovasc Surg. 2010; 26: 228-232Crossref Scopus (3) Google Scholar]. On July 28 of the same year, Dr N. Gopinath, at Vellore, successfully closed a ventricular septal defect using the heart-lung machine [3Gopinath N. Development of cardiovascular and thoracic surgery in India—golden era.Indian J Thorac Cardiovasc Surg. 2004; 20: S16-S19Crossref Scopus (2) Google Scholar]. Many surgeons in different centers began performing open procedures. First, cardiac pacing was reported by Dr C.C. Kar and A.K. Basu from Institute of Post Graduate Medical Education & Research Calcutta in 1966 and 1967 [7Das M.K. Kumar S. Deb P.K. Mishra S. History of cardiology in India.Indian Heart J. 2015; 67: 163-169Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar]. After years of research and practice on animals, Dr P.K. Sen and his teammates felt ready to perform human heart transplantation by 1965. However permission to transplant was denied by the state medical board, and they had to wait until the legendary first such operation by Dr Christiaan Barnard [6Parulkar G.B. Developments in cardiovascular surgery in India during last five decades.Indian J Thorac Cardiovasc Surg. 2004; 20: S24-S30Crossref Scopus (5) Google Scholar]. On February 16, 1968, Dr Sen performed the fifth heart transplant of the world (first in Asia), with limited survival success [9Hosain N. Dr P K Sen–the Bengali surgeon of the century.Cardiovasc J. 2011; 3: 254-257Crossref Google Scholar]. He attempted another transplantation on September 13 of the same year. He also introduced a procedure for neoangiogenesis through transmyocardial revascularization with acupuncture in 1967 and 1968 [5Stanley J. Cardiac surgery in India.Indian J Thorac Cardiovasc Surg. 2004; 20: S20-S23Crossref Scopus (3) Google Scholar, 9Hosain N. Dr P K Sen–the Bengali surgeon of the century.Cardiovasc J. 2011; 3: 254-257Crossref Google Scholar]. The Thoracic Surgeons' Association of India, the first association of this kind in the region, was founded in August 1954 at Vellore by Dr Reeves H. Betts, Dr Santokh Singh Anand, Dr A.K. Basu, Dr P.K. Sen, and Dr Sadashivan [10Sampathkumar A. Birth of a society.Indian J Thorac Cardiovasc Surg. 2004; 20: S3-S4Crossref Scopus (1) Google Scholar]. Dr Betts was elected president and Dr A.K. Basu as the secretary of the association. India has the earliest history of cardiac surgery, and as a result, there appears to be some lack of consensus regarding the dates and chronology of some events. Despite its smaller size of area and population, Sri Lanka, or the then Ceylon, was the second country of the region to start regular cardiac surgery program. Ceylon gained independence from Great Britain in 1948. The first closed heart surgery in Ceylon was performed by a visiting Danish surgeon Professor Husfeld in 1952. He visited Ceylon with a medical team sponsored by World Health Organization [112009 Kumudini Hettiarachchi. He wielded the scalpel like an artist. Sunday Times December 6, 2009. Available at http://www.sundaytimes.lk/091206/Plus/plus_10.html. Accessed July 26, 2016.Google Scholar]. Dr Arthur Terence Sahanandan Paul, popularly known as A.T.S. Paul, was the pioneer in cardiac surgery among the native surgeons. He established a thoracic surgery unit in 1951 at the then General Hospital of Ceylon, which today is the National Hospital of Sri Lanka. Initially dealing with tubercular patients, he later started doing closed heart procedures for patients with rheumatic mitral stenosis. Dr Paul gave a wonderful presentation in 1963 in front of the Sri Lankan surgeons describing the first decade of cardiac surgery (1953 to 1963) [12Paul A.T. A review of cardiac surgery.Sri Lanka J Surg. 1997; 15: 25-28Google Scholar]. Dr A.T.S. Paul was trained in the techniques of using cardiopulmonary bypass in Georgetown University in Washington, DC by Dr Charles Hafnazel [13Plarr's Lives of the Fellows Online. Biographical entry Paul, Arthur Terence Sahanandan (1915–2008) Royal College of Surgeons UK. Available at http://livesonline.rcseng.ac.uk/biogs/E002039b.htm. Accessed August 31, 2016.Google Scholar] and returned to Sri Lanka to use it. He performed the first open heart surgery in Sri Lanka at the General Hospital the same year. On June 15, 1968, the first intensive care unit in Ceylon was established by anesthetist Dr Thistle Jayavardhane for taking care of these cardiac surgical patients [14Ranatunga K. Presidential address. Anesthesia and critical care-past, present and the way forward.Sri Lankan J Anesthesiol. 2013; 21: 3-8Crossref Scopus (2) Google Scholar]. Dr Paul also designed a portable heart-lung machine and kidney dialysis machine [112009 Kumudini Hettiarachchi. He wielded the scalpel like an artist. Sunday Times December 6, 2009. Available at http://www.sundaytimes.lk/091206/Plus/plus_10.html. Accessed July 26, 2016.Google Scholar]. The second biggest country of South Asia, Pakistan gained independence in 1947. The two parts, namely West and East Pakistan, separated after a bloody civil war in 1971, the former solely constituting the Pakistan of today. A few sporadic closed heart surgical procedures, such as closed mitral valvotomy, patent ductus arteriosus closure, and pericardial effusion drainage, were performed at Karachi, Lahore, Rawalpindi, and Dhaka in the late 1950s and 1960s. The earliest open heart procedures of Pakistan are thought to have been performed by Dr Donald E. Bowes, a Canadian missionary surgeon, in 1967 and 1968 at the United Christian Hospital, Lahore [15Find a Grave Memorial. Dr Donald E Bowes. Available at http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=111798987. Accessed July 27, 2016.Google Scholar, 16Live Rostrum. United Christian Hospital–a neglected hospital of Lahore. Available at https://www.liverostrum.com/united-christian-hospital-uch-a-neglected-hospital-of-lahore/1015141.html. Accessed July 27, 2016.Google Scholar]. Dr Bowes was born in Imperial, Saskatchewan, Canada. He was trained in cardiac surgery at Pittsburgh and Michigan. He spent 15 years in that Pakistani missionary hospital. The service there was very cheap, a cardiac or pulmonary operation would cost as low as only $65 [17Provincial news-Ontario. Can Med Assoc J 1962;Jan:3–4.Google Scholar]. His legacy was lost because he failed to transfer technology to local surgeons. After retirement, Dr Bowes settled in the United States. The first open heart surgery was performed by a Pakistani team on March 4, 1970, at the Rawalpindi Military Hospital (Fig 2). The chief surgeon was Dr Lieutenant Colonel Ali Masood Akram, and the chief cardiologist was Dr Major M. Abdul Malik, representing the Western and Eastern parts of the then Pakistan, respectively. Also among the team were surgeon Captain M. Afzal Kiani and anesthetists Dr Major Faiz M. Khan and Dr Major Siddique. After the partition of Pakistan, regular open heart procedures began at National Institute of Cardiovascular Diseases in Karachi in the early 1970s. Dr Abdul Ghaffar Jatoi was the chief cardiac surgeon there [18Maher M. Humble cardiac surgeon Dr AG Jatoi, the maker of Mideast hospital, won the hearts just as he mended them.The Express Tribune. May 10, 2012; : 1Google Scholar]. At Dhaka closed heart operations began in the late 1960s when it still was the eastern part of Pakistan. Some bold general surgeons performed a few cases of closed mitral valvotomy at Dhaka Medical College Hospital and at the then Chest Hospital, which is the National Institute of Diseases of Chest and Hospital these days. The chief cardiologist of the pioneering Pakistani team, Major Malik, is a Bangladeshi and played a significant role in the development of cardiac care services in Bangladesh. Formal well-organized cardiac surgery began here with the establishment of Institute of Cardiovascular Diseases in 1978 by late president Ziaur Rahman, who introduced the original idea of regional cooperation in South Asia leading to the formation of South Asian Association for Regional Cooperation [19South Asian Association for Regional Cooperation. SAARC Charter day. Available at http://saarc-sec.org/Charter-Day/6/. Accessed September 12, 2016.Google Scholar]. The Institute of Cardiovascular Diseases, which was later renamed as the National Institute of Cardiovascular Diseases Dhaka, became the focal point of cardiac care onwards. At the initial phase, the Japan International Cooperation Agency and the Government of Japan provided technical and financial assistance. Massive exchange programs involving surgeons, anesthetists, cardiologists, nurses, and technicians from Japan and Bangladesh took place. The first open heart surgery was performed on September 18, 1981 [20Open heart surgery in Dacca. The Bangladesh Observer September 25, 1981;12.Google Scholar, 21Hosain N. Postal stamps & cardiac surgery.Cardiovasc J. 2013; 6: 74-78Crossref Google Scholar]. The patient was an 18-year-old college student. The chief surgeon was Dr Kome Saji from Japan and with him were 2 pioneering Bangladeshi cardiac surgeons, Prof M. Nabi Alam Khan and Prof Sirajur Rahman Khan, popularly known as S.R. Khan. These 2 legendary Khans were well known for their professional jealousy and personal friendship. The other Japanese surgeon of the team, Dr Tomino, served as the perfusionist at that first operation. Among the anesthetists of that operation were Dr Yishibashi Kishi (from Japan), Prof Khalilur Rahman, and Dr A.Y.F. Ellahi Chowdhury. Overseeing this event, Brigadier (Rtd) Abdul Malik had earned a rare distinction of being part of the pioneering cardiac surgery team of 2 countries, Pakistan and Bangladesh. For obvious reasons, this event received huge media coverage (Fig 3). The Bangladesh postal department issued a stamp and a first day cover commemorating the 30th anniversary of this event [21Hosain N. Postal stamps & cardiac surgery.Cardiovasc J. 2013; 6: 74-78Crossref Google Scholar]. The history of cardiac surgery in Nepal dates back to 1965, when Dr Dinesh Nath Gongal attempted a closed mitral valvotomy at Bir Hospital. The anesthetist, Dr G.P. Rajwalot, administered anesthesia using a Boyle machine with ether vaporizer [22Amatya R. Evolution of anesthesia in Nepal—a historic perspective.J Soc Anesthesiol Nepal. 2014; 1: 3-6Crossref Google Scholar]. Dr Gongal later performed a few more closed heart procedures at the same venue with limited success. Dr Lok Bikram Thapa and Dr Damodar Prasad Pokhrel were 2 dedicated surgeons who established a separate thoracic surgery unit at Bir Hospital and began performing closed heart operations. An Australian cardiac surgical team led by Dr Alain Gale made a few visits to Bir Hospital between 1985 and 1995 at Dr Pokhrel's invitation. An American team from Loma Linda University, led by Dr Leonard Lee Baily, also visited Nepal in the early 1990s and performed a few cases. Dr Govind Sharma started a thoracic unit at the Trivuban University Teaching Hospital (TUTH) in the 90s. Between 1995 and 1997, Americans continued visits to Nepal and performed open heart procedures, mainly ASD closure and open mitral valvotomies, at TUTH. The first open heart surgery by an all-Nepalese team was performed at TUTH on February 27, 1997 [23Koirala B. Beginning of open heart surgery programme in Nepal.J Nepal Med Assoc. 1998; 37: 447-448Crossref Google Scholar]. Dr Bhagwan Koirala was the pioneer surgeon of that operation along with Dr Govind Sharma and Dr B.M. Singh (Fig 4). The first aortic valve replacement in Nepal was performed on September 2, 1997. The open heart surgery program at TUTH continued with help from the Americans. Afghanistan was the sixth country of the region to start cardiac surgery. Surgeons of the French voluntary organization "La Chaine de l'Espoire" and the French Medical Institute for Children started cardiac surgery at Afghanistan in 2006 [24Institute for War and Peace Reporting. Afghanistan's first open-heart patient thriving. Available at https://iwpr.net/global-voices/afghanistans-first-open-heart-patient-thriving. Accessed July 28, 2016.Google Scholar, 25BBC News. Afghan becomes open heart surgeon. Available at http://news.bbc.co.uk/2/hi/south_asia/7293335.stm. Accessed July 27, 2016.Google Scholar]. A 13-year-old Afghan girl was the first patient to undergo open heart surgery in Afghanistan. The operation was performed by French surgeon Dr Alain Deloche with Afghan surgical assistance around. The British Broadcasting Corporation had reported that the first cardiac surgery by Afghan surgeon Dr Hashmatullah Nawabi was performed in 2008 [25BBC News. Afghan becomes open heart surgeon. Available at http://news.bbc.co.uk/2/hi/south_asia/7293335.stm. Accessed July 27, 2016.Google Scholar]. The French Institute popularly known as Mother and Children Hospital was inaugurated in April 2005 as a joint project run by the Agha Khan Development Network, the French organization "La Chaine de L'Espoir et Enfants Afghans," and the Afghan government. Afghanistan actually came very close to having a cardiac surgery program much earlier in the 1980s. During the years of Soviet occupation, equipment was imported to start open heart surgery there. But the equipment was never be used because it disappeared during the turmoil and looting at the time of fall of Communist regime in 1992 [24Institute for War and Peace Reporting. Afghanistan's first open-heart patient thriving. Available at https://iwpr.net/global-voices/afghanistans-first-open-heart-patient-thriving. Accessed July 28, 2016.Google Scholar]. South Asia, the most densely populated region of the world, is inhabited by more than 23% of the world's population. Obviously, this area has a huge burden of noncommunicable disease, including cardiac ailments. Cardiac surgery services began in the region mostly in the early 1950s. Some missionary and other foreign surgeons played significant role in the early days. India was the first country to establish cardiac surgery chronologically, followed by Sri Lanka, Pakistan, Bangladesh, Nepal, and Afghanistan. These events are summarized in Table 1. Two tiny nations, Bhutan and the Maldives, are yet to have their own cardiac surgical programs. Opening the historic chapters of these 6 countries under same heading has brought some great tunes.Table 1Milestones of Cardiac Surgery in South Asia at a GlanceTimePerson(s)PlaceEvent1946Dr K.M. ShahKEM Hospital, BombayFirst cardiac surgery, repair of left ventricle injury1948–49Dr Reeve H. BettsCMC, VelloreEstablished cardiothoracic department1949Dr BillimoriaMasina HospitalPDA closureFeb 27, 1951Dr Reeve H. BettsCMC, VelloreAortopulmonary shunt in a TOF patient1951Dr A.T.S. PaulGeneral HospitalEstablished cardiothoracic department1952Dr P.K. SenKEM, BombayFirst closed mitral valvotomy1952Dr HusfeldColombo, CeylonA closed heart procedureLate 1950sKarachi, Lahore, RawalpindiClosed heart procedures1956Dr P.K. SenKEM, BombayASD closure using surface hypothermia1959Dr A.K. BasuIPGME&R, CalcuttaAortic valvotomy using inflow occlusionFeb 16, 1961Dr K.N. DasturNair HospitalFirst ASD closure under CPB1966Dr A.T.S. PaulFirst open heart surgery in Sri Lanka1966–67Dr C.C. Kar and Dr A.K. BasuIPGME&R, CalcuttaFirst pacing1967–68Dr Donald E. BowesUCH, LahoreFirst open heart surgery in PakistanFeb 16, 1968Dr P.K. SenKEM, BombayFirst heart transplantation in AsiaMar 4, 1970Lt Col Akram and Major Abdul MalikFirst open heart by a Pakistani teamSep 18, 1981Dr M. Nabi Alam Khan and Dr S.R. KhanFirst open heart surgery in Bangladesh1985–95Australian teamBir HospitalClosed heart operations in NepalFeb 27, 1997Dr Bhagwan Korala and teamFirst open heart by Nepalese surgeons2006Dr Alain Doloche and teamFirst open heart in AfghanistanASD = atrial septal defect; CMC = Christian Medical College; CPB = cardiopulmonary bypass; IPGME&R = Institute of Post Graduate Medical Education and Research; KEM = King Edward Memorial; PDA = patent ductus arteriosus; TOF = tetralogy of Fallot; UCH = United Christian Hospital. Open table in a new tab
Publication Year: 2017
Publication Date: 2017-07-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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