Paul Corso, cardiac surgeon who performed high-risk procedure, dies at 74 - Washington Post thumbnail

Paul Corso, cardiac surgeon who performed high-risk procedure, dies at 74 – Washington Post

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As chief of heart surgery at MedStar Washington Hospital Center, there were times when Paul J. Corso had to shut a patient’s heart down for repairs. There would be no heartbeat. He also had to shut down the lungs. No breathing. He shut down the brain. No brain waves. “45 Minutes of Death,” Reader’s Digest titled an account in 1978 about one of Dr. Corso’s early surgeries in which he put a patient’s brain, heart and lungs temporarily out of service, using a method called “deep hypothermia,” to lower the patient’s body temperature to between 50 and 65 degrees. This would slow down his metabolism and his bodily need for oxygen. Then, for a short time, the body would be still enough for the finely delicate surgery to proceed. Dr. Corso, who retired from Washington Hospital Center in 2018, died June 10 at his home in McLean, Va. He was 74. The cause was amyotrophic lateral sclerosis, a neurodegenerative condition known as Lou Gehrig’s disease, said his wife Karen Corso. In a medical career spanning more than 40 years — at Washington Hospital Center and earlier at George Washington University Hospital — Dr. Corso was among a second-generation group of cardiac surgeons nationwide who, over thousands of operations, would help transform the deep hypothermia procedure from an innovative, ever-changing and high-risk medical rarity to surgery that, by 2000, had become almost routine. “We want heart surgery to be routine,” Dr. Corso told Washington Post columnist Bob Levey in 2001. “That’s why the more we do it, the better it is . . . Heart surgery is like walking through a woods full of bear traps; the first time you do it, you’re liable to be trapped. You do it 20 times, you’re less likely to be trapped.”

Dr. Paul J. Corso (Gary Landsman/Washington Hospital Center)
Dr. Corso worked in one of America’s major news centers, and it was inevitable that he would have high-profile journalists among his patients. At least two of them wrote stories about the experience. Robert G. Kaiser, a former Post managing editor, was one. Kaiser underwent heart surgery in 2003. His body temperature was brought down to 50 degrees, and his heart, brain and lungs were shut down. Under those conditions “in what sense is one alive?” he asked at a post-surgery meeting with Dr. Corso. “We know that you’re not dead,” the doctor told him. “We’ve created this situation. The cells are kept alive . . . They’re just not making electrical noise. Once you’ve warmed back up and we bring you back to normal,” the organs will start working again. In fact that is exactly what happened. “My heart started to beat again on its own, prompted into action by the warm blood’s effect on the heart’s own internal pacemaker,” Kaiser wrote in a long account for The Post’s Sunday magazine. Tad Szulc, a former New York Times foreign correspondent and freelance author, went under Dr. Corso’s scalpel for heart surgery in 1999, then was invited to witness the same operation on another patient. “I saw how the heart was disconnected . . . for 45 minutes, completely emptied of blood for ‘empty-heart surgery’ and replaced by a heart-lung machine pumping oxygenated blood into the patient’s body,” Szulc wrote in Parade magazine in 1999. “He had ‘good hands,’ which translates into good surgery,” said Dr. John M. Keshishian, a former medical colleague. “Consider him among the best cardiac surgeons in the USA, . . . one of the first to use profound hypothermia for stopping the heart and doing the operation and then restarting the heart.” Paul Joseph Corso was born in Winchester, Va., on Sept. 14, 1944, and grew up in Charles Town, W.Va., where his mother was director of nursing at a hospital. His father, who emigrated to the United States from Sicily in 1920 at 3 with his parents, became a railroad engineer. At 16, with his mother’s encouragement and help, Dr. Corso witnessed his first surgery: the removal of his own appendix. He was anesthetized below the waist and saw it all in mirrors placed strategically above the operating table. In high school he was valedictorian of his class and, in 1965, graduated from George Washington University after three years. He graduated from GWU Medical School in 1969, then did a surgical residency and cardiothoracic surgery training at GWU and at the Cleveland Clinic Foundation. In 1967, he married Karen Johnston, his only immediate survivor. In an interview shortly before his death, Dr. Corso said he picked heart surgery “because it was intellectually challenging.” Years earlier, he told Levey that heart surgeons were “aggressive, intelligent, driven people who have mental, emotional and physical endurance. We are born with all of these factors, but need to develop them into their highest form. Some people say heart surgeons are jerks, and we’re probably that, too.” Cardiac surgery was always Dr. Corso’s chosen specialty, but the shutting down of heart, lung and brain was also used in other procedures. In 1977 he participated in a 19-hour operation with a neurosurgeon at GWU hospital to remove a paralyzing and potentially fatal growth of a snakelike tangled mass of blood vessels at the base of a patient’s brain. For the surgeon to remove the deadly mass, Dr. Corso shut down the heart, lung and brain, and he cooled the patient’s blood to 65 degrees. This was “about the same temperature where President Carter wants you to keep your rooms,” Dr. Corso quipped to The Post, referring to the fuel shortage crisis of the Carter presidency. In 1981 Dr. Corso was on a Washington Hospital Center team of surgeons who removed an explosive bullet that failed to explode from the neck of a policeman who was wounded in the attempted assassination of President Ronald Reagan. The FBI lab told the hospital that the bullet lodged in the officer’s neck could explode at any time. “It was the surgeons’ job to remove it without blowing up the patient, themselves and the surgical staff,” according to a career summary prepared by Dr. Corso and his family. To find the exact location of the bullet without probing around for it — and possibly detonating it — they jury rigged a metal detector using a wire and a transistor radio. The bullet was extracted successfully and detonated by a Secret Service agent at a safe location. Away from his work, he liked “fast cars, old wine” and skiing from mountain tops, said his friend, John Keshishian. Dr. Corso retired with the observation that “surgeons and ballplayers should leave the field before they are asked.”
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