DeBAKEy CARDIOvASCuLAR JOuRNAL - Methodist Hospital

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Introduction For decades, Baylor College of Medicine’s Department of Surgery, chaired by Dr. Michael E. DeBakey, has led the way in developing treatments for cardiac and vascular diseases (Figures 1, 2). This document, presents the personal surgical results of Jimmy F. Howell, M.D., who over the course of 40 years has performed more than 27,500 cardiac or vascular procedures excluding general and thoracic surgical opportunities. To this day, now six years beyond the scope of this report, he maintains an active surgical schedule albeit at a lesser pace (Figures 3, 4). This impressive volume of work was conducted at The Methodist Hospital, known for its excellence in the treatment of cardiac and vascular diseases — where the origins of modern vascular surgery came alive with the pioneering abdominal aorta and carotid artery operations performed by Dr. DeBakey in the early 1950s. The majority of Dr. Howell’s surgical procedures were performed during the late 1970s to early 1990s, the formative years of cardiac and vascular surgery at Baylor College of Medicine and The Methodist Hospital (Figures 5, 6). Acquired heart disease accounted for 43% of patients in this cardiovascular series. Coronary artery bypass (CABG) operations were the most common procedures. This was due in part to the pioneering work conducted by the cardiovascular surgeons at Baylor College of Medicine and The Methodist Hospital in the early 1960s, including the first successful bypass operation performed by Harvey E. Garrett, M.D. with the assistance of Jimmy F. Howell, M.D. in 1964 with encouragement and support of Dr. DeBakey (Figure 7). Their work, and the work of others at the Cleveland Clinic Foundation, established the basis for what is now the most frequently performed heart operation in the world. Figure 1. Michael E. DeBakey, M.D. Figure 4. Jimmy E. Howell, M.D. Figure 2. Jimmy E. Howell, M.D. Figure 3. Jimmy E. Howell, M.D. 4 vII (1) 2011 | MDCvJ
OTHER CHEST 8.96% Figure 5. Surgical procedures Figure 7. 7-year follow-up of the still-functioning bypass graft from the first successful coronary artery bypass by Drs. Garrett and Howell at The Methodist Hospital in 1964. 800 700 600 500 400 300 200 100 0 VALVES 8.28% PVI 10.33% CVI 10.67% 137 16 10.4% 1965-1975 Cases 153 UPPER EXTREMITY 3.56% 689 GENERAL SURGERY 17.13% 85 10.9% 1976-1985 Cases 774 CABG 35.07% CABG with associated procedures = 2,093 OP survival = 1,851 OP death = 242 11.5% 698 100 12.5% 1986-1995 Cases 798 Figure 9. CABG with associated procedures 327 41 10% 1996-2005 Cases 368 Figure 6. Total cases by year Figure 8. CABG only; STS benchmark 2002 = 5%, 2006 = 4% Primary Coronary Artery Bypass Dr. Howell performed 9,634 primary coronary artery bypass procedures. There were 9,425 survivors and 209 30-day operative deaths for a 30-day mortality of 2.1% (Figure 8). During the second and third decades of Dr. Howell’s practice, the mortality rate for his patients ranged between 1.7 and 1.9%, well below the national STS benchmark of 2.6%. The mortality for isolated CAB in the fourth decade was 2.4%, a slight increase from the previous three decades attributed to increased complexity of the cases. Coronary Artery Bypass with Associated Procedures Coronary artery bypass combined with other major surgical operations comprised 2,093 cases in this series (Figure 9). The most common additional procedures were valve replacement or repair, carotid artery recon- MDCvJ | vII (1) 2011 5 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 1,600 51 3% 1965-1975 Cases 1,651 3,933 80 1.9% 1976-1985 Cases 4,013 CABG only = 9,634 OP survival = 9,425 OP death = 209 2.1% 3.0% 2,726 49 1.7% 1986-1995 Cases 2,775 1,166 29 2.4% 1996-2005 Cases 1,195
Page 1 and 2: Volume 7, Number 1 • Jan. - Mar.
Page 3 and 4: W.L. Winters Jr., M.D. EDITOR’S N
Page 5: Every generation has its heroes. Dr
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Page 11 and 12: mitral valve operations. In most ca
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Page 21 and 22: W.S. Henly, M.D. PRIvATE PRACTICE O
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MuseuM of tMH MultiModality iMaging
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Introduction CT Coronary Angiograph
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sequences that offer superior signa
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MetHodist de Bakey Heart & VasCular
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My yEARS WITH MICHAEL E. DeBAKEy Lo
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poet’s pen WHY I AM NOT A BUDDHIS
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To the Editor: After reading Dr. Be
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6565 Fannin Street Houston, Texas 7
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DeBAKEy CARDIOvASCuLAR JOuRNAL - Methodist Hospital

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