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Open-Heart Surgery 心脏直视手术 Without a steady supply of fresh blood, without the oxygen it carries, the human brain is quickly impaired. In four minutes, brain cells, starved for oxygen, begin to die, and serious brain damage results. In another few minutes, the brain is completely destroyed. 如果心脏不能稳定供给新鲜血液，运输氧气，人的大脑很快就会受损。脑细胞在四分钟之内缺氧，就会开始死亡，最终造成严重的大脑损伤。 再缺氧几分钟，脑部就会完全损坏。 This was the crux of a stubborn problem. The heart could not be taken out of action for more than four minutes—very little time to repair a heart defect. Until a solution could be found, operating on the open heart would be impossible. 这就是心脏手术这个难题的关键所在心脏不能停止跳动超过四分钟 The two major advances pointed the way to open-heart surgery. One was hypothermia, the artificial lowering of the body temperature. Body tissues need far less oxygen when the body is chilled. A “frozen” brain, for example, requires only half as much oxygen as one with a normal body temperature of 98.6 Fahrenheit. This means it can do without fresh blood for longer than four minutes and not suffer damage. In 1950, a Canadian professor, Wilfred G. Bigelow of the University of Toronto made this important discovery, and he immediately saw that hypothermia might give heart surgeons the chance “to operate on a bloodless heart.” With hypothermia, a surgeon could clamp off arteries leading to the heart and stop blood flowing into it. He could copen the heart, drain it of excess blood, and operate in a “dry field” for more than five minutes. Two years later Dr. Floyd John Lewis of the University of Minnesota tried open-heart surgery with hypothermia. The day after the operation his five-year-old patient was walking, and she was discharged from the hospital ten days later. 有两项主要进步给心脏直视手术指明了方向。一个是降低体温，人工降低体温。体组织在身体冷却的状态下需要的氧气远比正常情况少。比如说一个“冻结的”大脑需要的氧气，是正常体温华氏98.6度下需要的氧气的一半。这意味着大脑可以缺氧超过四分钟并且不造成任何伤害。1950年，一个加拿大的专家，多伦多大学的威尔弗雷德.G.比奇洛做出了这个重要发现，而且他立刻就意识到降低体温可能给心脏外科医生提供“无血心脏手术”的机会。在降低了体温的条件下，外科医生可以夹住通向心脏的动脉，止住流向心脏的血液。医生可以打开心脏，排出过多的血液，然后在“干燥的区域”动手术超过五分钟。两年后，