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Department of Surgery

About

Horace G. Smithy, MD

Horace G. Smithy Photo

Our institution played a pioneering role in the early days of cardiac surgery. Horace Smithy came to the Medical College of South Carolina in 1938 as a resident in surgery. Upon completing his residency he remained on the faculty and in fact was only the third full-time faculty appointment in Surgery at MUSC. At that time rheumatic fever was widespread throughout the South as well as of course rheumatic heart disease. Dr. Smithy was quite interested in this and developed this valvulotome pictured here. This is a crude instrument which he made in the machine shop consisting of a plunger with a set of jaws on the end which opened and closed.

Valvulatome Photo
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Illustration1
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In this illustration by Leon Sclossberg, this instrument was designed to be inserted through a pursestring suture in the apex of a beating heart and thus at our institution we take credit for some of the earliest beating heart surgery, positioned precisely in a stenotic mitral valve, and when the plunger was depressed, it would theoretically bite out a portion of this stenotic valve thus enlarging the opening and relieving the stenosis.  This illustration shows the plunger removed, the pursestring suture tied, and the enlarged opening in the mitral valve. Dr. Smithy performed many animal experiments and presented his work at the American College of Surgeons. He was fairly quickly deluged by requests from patients all over the country, as again many people were dying of heart failure related to mitral stenosis.

Illustration2
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New York Times Photo
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On January 29, 1948, he operated upon a young lady, Betty Lee Woolridge, and these are the headlines from the New York Times describing this operation. She survived, and is shown here with Dr. Smithy as she boards a plane to return to Canton, Ohio which was her hometown. Dr. Smithy then operated on about six other patients, four of whom survived at least for a short time, and then it became apparent why he was so interested in the problem of rheumatic heart disease. This was because Dr. Smithy himself had rheumatic aortic and mitral stenosis. He took his valvulotone to Dr. Alfred Blalock at Johns Hopkins and asked Dr. Blalock to use it and operate on him. Dr. Blalock was cautious and suggested that Dr. Smithy bring a patient to Hopkins from Charleston and that they operate together. A patient was subsequently brought to Hopkins but unfortunately died during induction of anesthesia, and before another patient could be scheduled, Dr. Smithy himself died from complications of heart failure from rheumatic heart disease.

Smithy and Betty Lee Woolridge Photo
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Smithy Obituary Photo

This is his obituary from the New York Times. The most important thing is that is that Dr. Smithy was only age 34 years old at the time of his death, or younger than most cardiothoracic residents in training today. Yet by this age he had already made significant contributions to the field. Dr. Smithy’s family subsequently endowed a visiting professorship in his name at MUSC and then a chair in surgery—The Horace Smithy Endowed Chair in Surgery. Dr. Fred Crawford was the first recipient of theHorace Smithy Chair (1997-2009). Dr. John Ikonomidis is the current Horace Smithy Chair.

Smithy Photo
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