Historical perspectives of The American Association for Thoracic Surgery: John H. Gibbon, Jr (1903-1973)


PRESIDENTIAL PERSPECTIVES
Historical perspectives of The American Association for Thoracic
Surgery: John H. Gibbon, Jr (1903-1973)
Thomas P. Theruvath, MD, PhD, and John S. Ikonomidis, MD, PhD
BIRTH AND UPBRINGING
John Heysham Gibbon, Jr, 41st President of The American
Association for Thoracic Surgery (AATS), was born on
September 29, 1903, as the first son to Marjorie Glendolyn
Young Gibbon and John Heysham Gibbon, at their home at
332 South 15th Street, in Philadelphia, Pa. Philadelphia was
home to 5 generations of Gibbons. The first American
Gibbon had emigrated in 1684 from Wiltshire, England.
John H. Gibbon, Jr, came from a long line of physicians,
starting back in England, where his great-great-great grand-
father had been a London physician. Furthermore, 2 previ-
ous generations of Gibbons were graduates of Jefferson
Medical College. His father was a respected surgeon and
co-chairman of the Department of Surgery at Jefferson
and had held many honorable positions, including the pres-
idency of the American Surgical Association. Although his
father was his counselor in later years, his mother was more
influential during his childhood. Marjorie Gibbon came
from the West and was the daughter of a distinguished
career officer. She taught him the value of books, and they
both indulged in reading during any spare time. She devel-
oped his curiosity in literature, philosophy, and poetry,
which would be a major interest for the rest of his life.
John H. Gibbon, Jr, or Jack, as he was called, had an older
sister, Marjorie, and was the older brother to Sam and Rob-
ert. As a determined and competitive child, he became an
excellent athlete, including tennis, and horse rider, which
was fostered on the family’s 150-acre farm.1
FIGURE 1. Professor John Heysham Gibbon, Jr.
EDUCATION AND SURGICAL TRAINING
John Gibbon, Jr, entered Princeton College just before his

16th birthday and matriculated at Jefferson Medical College
in 1923 at age 20. Regrets of not following his longing to
pursue literature and poetry studies marked the initial years.
At one point, he had decided to quit medical school so he
could continue his literature studies. However, after consul-
ting with his father, whose ideas and proposals he valued, he
decided to continue medical school. He described the initial
From the Division of Cardiothoracic Surgery, Medical University of South Carolina,

Charlotte, SC.

Disclosures: Authors have nothing to disclose with regard to commercial support.

Received for publication Oct 14, 2013; accepted for publication Nov 6, 2013;

available ahead of print Dec 12, 2013.

Address for reprints: John S. Ikonomidis, MD, PhD, Division of Cardiothoracic Sur-

gery, Medical University of South Carolina, 25 Courtenay Dr, Suite 7030,

Charleston, SC 29425 (E-mail: ikonomij@musc.edu).

J Thorac Cardiovasc Surg 2014;147:833-6

0022-5223/$36.00

Copyright � 2014 by The American Association for Thoracic Surgery
http://dx.doi.org/10.1016/j.jtcvs.2013.11.007

The Journal of Thoracic and Ca
years of medical school as ‘‘boring with needless memori-
zation.’’1 Nevertheless, he was a fast and dedicated learner,
mastering the final clinical years, and finished medical
school in 1927. Without any doubt, this was the correct de-
cision, as the global medical community would witness 27
years later.
After finishing medical school at Jefferson, he continued

with a 2-year internship at the Pennsylvania Hospital. His
interest in general thoracic surgery led him to contact Dr
Edward Delos Churchill (28th AATS president), who was
one of the significant figures in the early development of
surgery for lung cancer. He had an active laboratory and
later became chief of general surgical services at Massachu-
setts General Hospital. Gibbon pursued a research fellow-
ship position in Dr Churchill’s laboratory and in 1930
rdiovascular Surgery c Volume 147, Number 3 833

Delta:1_given name
Delta:1_surname
mailto:ikonomij@musc.edu
http://dx.doi.org/10.1016/j.jtcvs.2013.11.007


FIGURE 2. Dr Gibbon’s first version of the heart–lung machine (IBM I).

This machine was used up to 1951 in experimental canine models.

Presidential Perspectives Theruvath and Ikonomidis
started to perform feline experiments to investigate the me-
chanical influences of the pericardium on cardiac function
and the physiologic changes of an increasing pulmonary ar-
tery pressure such as occurs in pulmonary embolism.2,3

Together with Mary Hopkinson, Dr Churchill’s research
assistant, and later Dr Gibbon’s wife, they published very
efficiently in highly ranked journals such as the Journal
of Clinical Investigation and Annals of Surgery.2-4

SURGICAL CAREER
After an internship and clinical fellowships at the Penn-

sylvania Hospital, Dr Gibbon became a faculty member
as a surgeon in 1937 and later an assistant professor of sur-
gery at the University of Pennsylvania in 1945. During
World War II, John Gibbon, Jr, volunteered for duty and
was in the United States Army from 1942 to 1945. He
served as major and lieutenant colonel on the surgical ser-
vice for the 52nd Evacuation Hospital in the South Pacific
and later at Mayo General Hospital. In 1946, he returned
to his alma mater at the Jefferson Medical College, where
he quickly ascended to the rank of full professor and in
1956 became the Samuel D. Gross professor of surgery
and chairman of the department of surgery (Figure 1). He
remained the head of the department and also a consultant
surgeon at the Pennsylvania Hospital and Veterans Affairs
Hospital in Philadelphia until his retirement in 1967.5

CURRICULUM VITAE HIGHLIGHTS
Although Dr Gibbon will always be known as the inven-

tor of the cardiopulmonary bypass machine, he also made
several other clinical contributions. He served on the edito-
rial board of Annals of Surgery from 1947 to 1973 and was
its chairman from 1947 to 1957. He authored the textbook
Surgery of the Chest,6 which is in its 8th edition and has
set the standard as a reference in the field of cardiothoracic
surgery. He was a member of the examination committee of
the American Board of Surgery from 1953 to 1956 and
served as its chairman from 1955 to 1956. He was president
of the American Surgical Association in 1954, the AATS for
1960 to 1961, the Society of Vascular Surgery for 1964 to
1965, and the Society of Clinical Surgery for 1953 to
1954 and was elected to the National Academy of Sciences
in 1972. Among his numerous awards was the Albert
Lasker Clinical Research Award, which he received in
1968, often referred to as the American Nobel prize.1,7,8

ACCOMPLISHMENTS AND CONTRIBUTIONS TO
THE FIELD OF CARDIOTHORACIC SURGERY

Dr Gibbon’s pursuit of advancing medicine was fueled by
the well-described event in Boston in October of 1930,
when a young woman, after an uneventful cholecystectomy,
developed severe onset of chest discomfort and difficulties
breathing, consistent with acute pulmonary embolism. She
was moved to the operating room for constant close
834 The Journal of Thoracic and Cardiovascular Surg
observation. It was Dr Gibbon who was given the responsi-
bility to assess her clinically and to document her pulse, res-
piratory rate, and blood pressure every 15 minutes starting
at 3 PM that day. He was ordered to inform Dr Churchill
immediately when her vital signs would deteriorate so
that an emergent embolectomy could be performed. Dr
Gibbon reported that at 8 AM the next day, she had become
apneic and was without a measurable blood pressure. Dr
Churchill opened her chest, incised the pulmonary artery,
removed the blood clot, and placed a side-biting clamp on
the pulmonary artery, all within less than 7 minutes. This
patient, however, died, just as had most of the patients for
whom Dr Friedrich Trendelenburg had described this tech-
nique in Leipzig, Germany, 23 years earlier. For Dr Gibbon,
it was this event that sparked the idea of a cardiopulmonary
bypass machine, which would, 23 years later, advance and
revolutionize the entire field of cardiothoracic surgery. He
described his thoughts9 as follows:

During that long night, watching helplessly the pa-
tient struggle for life as her blood became darker
and her veins more distended, the idea naturally
occurred to me that if it were possible to remove
some of the blue blood from the patient’s swollen
veins, put oxygen into that blood and allow carbon di-
oxide to escape from it, and then inject continuously
the now-red blood back into the patient’s arteries, we
might have saved her life. We would have bypassed
the obstructing embolus and performed part of the
work of the patient’s heart and lungs outside the body.

During the next 2 decades, he continued his search for a
heart–lung substitute, tireless and with utmost persever-
ance. A fruitful collaboration with IBM Corporation al-
lowed him to develop and assemble a first model of a
bypass machine, which was successfully used in canine ex-
periments (Figure 2).10 An upgrade of his cardiopulmonary
bypass machine allowed increased blood flow, allowing its
use in humans (Figure 3). On May 6, 1953, at the
ery c March 2014



FIGURE 3. Dr Gibbon and his wife Mary (‘‘Maly’’) Gibbon with the

newer version of the heart–lung machine (IBM II). This was the second

and more refined model that Dr Gibbon used on his first patients.

FIGURE 4. May 6, 1953: The Bavolek operation. Drs Gibbon (left) and

Frank Allbritten (right) performing the first successful open heart surgery

to close an atrial septal defect in Cecilia Bavolek.

FIGURE 5. Dr Gibbon during his retirement at his family homestead in

1970.

Theruvath and Ikonomidis Presidential Perspectives
Pennsylvania Hospital, the first successful use of
Dr Gibbon’s heart–lung bypass machine was used on an
18-year-old woman, named Cecilia Bavolek. She had
been diagnosed with an atrial septal defect, which had
been undiagnosed until then, given the insufficient diag-
nostic modalities of the previous era. Although her parents
had been told of some congenital heart disease, she had re-
mained asymptomatic until she necessitated admission for
severe fatigue and hemoptysis. Dr Gibbon operated with
Dr Frank Allbritten (who had invented the left ventricular
apex vent) and 2 of his residents using his heart–lung ma-
chine.11,12 By way of a clamshell incision, the defect was
repaired primarily. The heart and lung functions were
bridged with cannulation of the left subclavian artery and
bicaval venous cannulation for 26 minutes (Figure 4). Ceci-
lia Bavolek had an uneventful recovery and was discharged
home on postoperative day 13.

8,13

Dr Gibbon’s creative imagination, which was sparked in
1930 from the inability to help a dying patient, and his dedi-
cation and perseverance in designing an efficient heart and
lung substitute, led to the landmark operation in 1953.
Although other national and international centers were ex-
perimenting in an effort to assemble a heart–lung machine
for clinical use in the late 1940s and 1950s, it was John
The Journal of Thoracic and Ca
Gibbon’s work as a physician and scientist in its ultimate
definition that led to the first successful and safe conduct
of open cardiac surgery. However, both of his subsequent
patients whom he operated on a few months later using
his heart–lung bypass machine died during the procedure.
Deeply disappointed by these failures to rescue these pa-
tients, he chose to let additional clinical use of his machine
be performed by others in the field. It is hardly surprising
that he has been called the ‘‘father of extracorporeal circu-
lation.’’ To honor Dr Gibbon at Thomas Jefferson Univer-
sity in Philadelphia, his alma mater, one of the university
hospital buildings has been renamed the ‘‘Gibbon
Building.’’
SUMMARY OF AATS PRESIDENTIAL ADDRESS
The presidential address of Dr John H. Gibbon, Jr, ‘‘The

Road Ahead for Thoracic Surgery,’’ presented at the 41st
rdiovascular Surgery c Volume 147, Number 3 835



Presidential Perspectives Theruvath and Ikonomidis
annual meeting of the AATS, in Philadelphia, April 24 to
26, 1961, was influenced by his extremely successful physi-
cian and scientist career in an era when significant contribu-
tions to cardiothoracic surgery had climaxed and
revolutionized the field.14

He started by explaining how the field of thoracic surgery
had slowly matured from an embryonic state in 1917, when
the AATS was founded, to a youthful state in 1961, and that
it still had not attained maturity. He gave examples of the
advancements in thoracic, cardiac, and pediatric cardiac
surgery, including his own contribution of using his cardio-
pulmonary bypass machine to perform safe open heart sur-
gery. He delineated how these early advancements were
only possible because of concomitant advancements and
developments in other fields of medicine, such as the devel-
opment of heparin, antibiotics, and a better understanding
of cardiopulmonary physiology. Dr Gibbon stated that
‘‘much remains to be done,’’ specifically, increasing the
safety of thoracic operations and understanding the physi-
ology of cardiac ischemia and hypothermia-induced slow-
ing of metabolic demand. The proposed transition of
thoracic surgery from its youth in the 1960s to manhood
is what Dr Gibbon presented in the second part of his pres-
idential address.

He documented that in an era of funding abundance in
which the Department of Health, Education, and Welfare
had increased their spending fourfold from 1953 to 1958
and with well-equipped laboratories, the essential require-
ment was well-trained physician-investigators. He then
asked the question of whether enough young medical stu-
dents and physicians have been properly educated in the
methods of scientific education and have engaged in
research. Dr Gibbon emphasized that a good researcher
needs qualities such as honesty, integrity, passion, patience,
persistence, and attention to detail and must be incorrupt-
ible. He noted that many with these qualities might have
no interest in research, but instead in teaching, and should
not be institutionally forced into conducting experimental
investigations. As such, he proposed that every academic
institution should have positions designed solely for teach-
ing and others solely to conduct research.

He then stated that, during surgical education, at least 1
year should be spent in a laboratory, where the young sur-
geon in training will, at a minimum, become a critical reader
of surgical published studies. After the formal surgical edu-
cation, ‘‘the embryo surgeon’’ should pursue a second
period of research, preferably at a different institution, to
give young clinicians and investigators greater experience
and the basics of conducting bench research. He empha-
sized the significance of a good mentor, teacher, and inves-
tigator. He finished his presidential address by providing 6
836 The Journal of Thoracic and Cardiovascular Surg
common errors in conducting research and the notion that
fewer, but more concentrated, endeavors of the society
toward properly motivated and qualified investigators will
result in more significant contributions.

PERSONAL LIFE
Dr John H. Gibbon, Jr, met his wife Mary Hopkinson, or

Maly as she was known to most, at the age of 30. Mary was
the daughter of Charles Hopkinson, one of America’s great-
est portraitists. They met as he started his research fellow-
ship in February 1930, in Boston, where Maly was
working as Dr Edward D. Churchill’s laboratory assistant
at the Massachusetts General Hospital. They married on
March 14, 1932, and had 4 children, Mary, John, Alice,
and Marjorie. Gibbon retired from his chairmanship in
1967 and from then on indulged in poetry, painting, and
sports, spending most of his time at the farm (Figure 5).
A devastating heart attack took his life on the tennis court
on February 5, 1973, at the age of 69.

Figures 1 to 5 have been provided courtesy of the Archives and
Special Collections, Thomas Jefferson University, Philadelphia,
Pa. The authors would like to thank F. Michael Angelo, MA, Uni-
versity Archivist, Thomas Jefferson University, for his assistance
in providing the images.
References
1. Shumacker HB. A Dream of the Heart. Santa Barbara: Fithian Press; 1999.

2. Gibbon JH, Churchill ED. The mechanical influence of the pericardium upon

cardiac function. J Clin Invest. 1931;10:405-22.

3. Gibbon JH, Hopkinson M, Churchill ED. Changes in the circulation produced by

gradual occlusion of the pulmonary artery. J Clin Invest. 1932;11:543-53.

4. Gibbon JH, Churchill ED. The physiology of massive pulmonary embolism: an

experimental study of the changes produced by obstruction to the flow of blood

through the pulmonary artery and its lobar branches. Ann Surg. 1936;104:811-22.

5. Shumacker HB. John Heysham Gibbon, Jr.: September 29, 1903–February 5,

1973. Biogr Mem Natl Acad Sci. 1982;53:213-47.

6. Gibbon JH. Surgery of the Chest. Philadelphia: WB Saunders; 1962.

7. Bing R. John H. Gibbon, Jr. Cardiopulmonary bypass—triumph of perseverance

and character. Clin Cardiol. 1994;17:456-7.

8. Cohn LH. Fifty years of open-heart surgery. Circulation. 2003;107:2168-70.

9. Gibbon JH Jr. The development of the heart–lung apparatus. Rev Surg. 1970;27:

231-44.

10. Miller BJ, Gibbon JH Jr, Greco VF, Smith BA, Cohn CH, Allbritten FF Jr. The

production and repair of interatrial septal defects under direct vision with the

assistance of an extracorporeal pump-oxygenator circuit. J Thorac Surg. 1953;

26:598-616; discussion 31-2.

11. Miller BJ, Gibbon JH Jr, Greco VF, Cohn CH, Allbritten FF Jr. The use of a

vent for the left ventricle as a means of avoiding air embolism to the sys-

temic circulation during open cardiotomy with the maintenance of the

cardiorespiratory function of animals by a pump oxygenator. Surg Forum.

1953;4:29-33.

12. Hedlund KD. A tribute to Frank F. Allbritten, Jr.: origin of the left ventricular vent

during the early years of open-heart surgery with the Gibbon heart–lung machine.

Tex Heart Inst J. 2001;28:292-6.

13. Gibbon JH Jr. Application of a mechanical heart and lung apparatus to cardiac

surgery. Minn Med. 1954;37:171-85.

14. Gibbon JH Jr. The road ahead for thoracic surgery. J Thorac Cardiovasc Surg.

1961;42:141-9.
ery c March 2014

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	Historical perspectives of The American Association for Thoracic Surgery: John H. Gibbon, Jr (1903-1973)
	Birth and Upbringing
	Education and Surgical Training
	Surgical Career
	Curriculum Vitae Highlights
	Accomplishments and Contributions to the Field of Cardiothoracic Surgery
	Summary of AATS Presidential Address
	Personal Life
	References