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Forssman, Werner (Theodor Otto)

heart method passing catheter

(1904–79) German physician: introduced cardiac catheterization.

Born in Berlin, Forssman attended school and studied medicine there before going in 1929 to a hospital at nearby Eberswalde to continue clinical studies in surgery. He became interested in the problem of delivering a drug rapidly and safely to the heart in an emergency; at that time, the best but unsafe technique was to inject directly through the chest wall. Forssman tried passing a catheter (a narrow flexible tube) into a vein near the elbow, using corpses in the hospital mortuary for his first trials. Then he tried the method on himself, passing the tube into his own antecubital vein for about 65 cm before walking to the X-ray department, where a radiographer held a mirror to the X-ray screen while Forssman fed the catheter into the right atrium of his heart. The method had clear potential, but it was severely criticized in Germany as dangerous and Forssman had little support. It was used to a limited extent in Lisbon and in Prague, but was undervalued and full use began only in New York’s Bellevue Hospital after 1940, when the method was used to extend knowledge of the heart and was shown to be suitable for routine use by A F Cournand (1895–1988) and D W Richards (1895–1973). Catheters with pressure gauges, or a device to collect samples of blood gases, enabled further study of heart action in health and disease. Passing a radio-opaque dye into the catheter while taking X-ray pictures on cine film allows the blood vessels and chambers of the heart to be studied (angiography). This method of contrast radiography is a routine procedure for examination of the heart valves before and after surgical repair, and of the coronary arteries as a preface to bypass surgery in cases of obstruction of these arteries.

Forssman served as an army surgeon in the Second World War, became a prisoner of war and afterwards specialized in urology. He shared the Nobel Prize for physiology or medicine in 1956 with Cournand and Richards.

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