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When open-heart surgery began in 1953, surgeons found it was virtually impossible to operate on the heart while at the same time expecting the heart to maintain its normal functions. Heart-lung machines were developed to circulate the patient's blood outside the body and to maintain certain body temperatures during surgery. These machines solved the problem of maintaining stable bodily functions during the operation so that the heart could resume its normal functioning following the operation. Those who operated the early heart-lung machines were not specifically trained for this subspecialty but, rather, came from the ranks of respiratory therapists, operating room technologists, biomedical and laboratory technologists, and nurses. These early heart-lung machine operators were often called pump technicians, perfusion technicians, extracorporeal technologists, and extracorporeal perfusionists.

From the mid-1950s until 1968, perfusionists were trained primarily by apprenticing under existing practitioners. In 1968, the American Society of Extracorporeal Technology (AmSECT) instituted a program of perfusionists' certification that the American Medical Association recognized with formal status in the 1970s. Also at this time, the American Board of Cardiovascular Perfusion (ABCP) was established. In 1980, the ABCP established formal requirements for the education and accreditation of perfusionists.

Reflecting the increased sophistication and specialization of open-heart surgery, perfusionism has grown more complex. The job of the perfusionist now includes putting together and operating the heart-lung machine, the artificial heart, blood transfusion devices, the intra-aortic balloon pump, and various ventricular-assist devices. However, during the past decade, changes in lifestyle and improvements in the treatment of cardiac disease have resulted in a decline in cardiac surgical procedures, resulting in a decline in the number of patients undergoing cardiopulmonary bypass. Perfusionists have been challenged with identifying new opportunities and have expanded their practices in the areas of perioperative blood management, wound healing, ventricular assistance, and expanded uses of extracorporeal circulation.

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