Cardiac surgery in Stockholm grew on a sound foundation of well-developed general thoracic surgery. The portal figure is Clarence Crafoord (1899-1983) who already in 1927 had succeeded with the Trendelenburg pulmonary
embolectomy operation. He went on to develop lung surgery in general. With foresight he stimulated the chemists of Karolinska Institute to purify
heparin, first for prophylaxis against
venous thromboembolism and later for use with the
heart-lung machine. In 1944 he became the first surgeon to successfully operate on patients with
coarctation of the aorta. With Viking Olov Bjork and Ake Senning the
heart-lung machine was improved, finally allowing its clinical use in a patient operated in 1954 for a
myxoma of the left atrium, with long-term survival. This was the first successful use of the
heart-lung machine in Sweden and the second in the world. He and his coworkers, first at the Sabbatsberg hospital and from 1957 at the Karolinska hospital made major contributions to cardiology and radiology, apart from the progresses in cardiac surgery. Contributions such as pressure recording from the left atrium by needle
puncture in 1950, the
Senning operation for transposition of the great arteries and the first use of a totally implantable cardiac pacemaker in 1958 are indeed medical history.