Co-authored with JW Dushane, RT Patrick, DE Donald, PS Hetzel and EH Wood,

"Kirklin refined the heart-lung machine (screen type) originally developed by Gibbon, to the point that it allowed the person to receive oxygenated blood, temporarily providing a blood free environment to work on the heart.^[11][12][13] In 1954, Kirklin's rival, C. Walton Lillehei used the technique of cross circulation to operate on an 11-month-old baby who died on the 11th day after surgery. Usually using the parent for cross circulation, he performed 45 operations of ventricular septal defects (VSDs), ASDs and tetralogy of Fallot. 30 survived and 20 were still alive 50 years later.^[10]

"Following the experimental trial in dogs, which by 1955 had demonstrated a 90% survival following heart-lung bypass, Kirklin's team were granted permission by the governance of the Mayo Clinic to go ahead with a clinical trial in eight children, using the machine. In March 1955, the first child survived a repair of a VSD.^[9] In this planned series of clinical cases, a 50% survival was reported. This was the first clinical series of open heart surgeries performed with a mechanical pump-oxygenator. Prior to this, the conditions were predominantly fatal. He therefore performed the world’s first successful series of open heart operations using the heart-lung machine. The Board of Governors at the Mayo Clinic approved the first eight operations, of which 4 (50%) survived.^[11]

As a result, open heart surgeries and repairs of some heart defects could be performed under direct vision routinely and with a high degree of success. Kirklin's modifications and team work also allowed repairs of tetralogy of Fallot.^{[6][7][10][11]} "(Wikipedia article on John W. Kirklin, accessed 10-2019).