Richard Van Praagh

Richard Van Praagh was born in London, Ontario on April 11, 1930. Moving with his family to Toronto at the age of 2, he grew up there and graduated from the Faculty of Medicine of the University of Toronto in 1954.

Then followed 12 years of postgraduate work: a rotating internship at the Toronto General Hospital; an internship in Pediatrics at the Hospital for Sick Children in Toronto (under the direction of Lawrence Chute, M.D,); an Assistant Residency in Pathology (John Craig, M.D. and Sidney Farber, M.D.,) and a Senior Assistant Residency in Pediatrics (Charles A. Janeway, M.D.) at the Children’s Hospital in Boston; a Senior Residency in Internal Medicine at Sunnybrook Hospital in Toronto; a Fellowship in Pediatric Cardiology at Johns Hopkins Hospital in Baltimore (Helen B. Taussig, M.D.); a Fellowship in Cardiopulmonary Physiology at the Mayo Clinic in Rochester, MN (Jeremy Swan, M.D.); a Senior Research Fellowship in Pediatric Cardiology at the Hospital for Sick Children in Toronto (John D. Keith, M.D. and Richard D. Rowe, M.D.); Associate Pathologist and then Assistant Director of the Congenital Heart Disease Research and Training Center at the Hektoen Institute for Medical Research in Chicago (Maurice Lev, M.D.); and Visiting Scientist in the Department of Embryology of the Carnegie Institution of Washington, in Baltimore (Robert deHaan, Ph.D.).

In 1965, Dr. Richard Van Praagh was invited by Drs. Alexander S. Nadas, Sidney Farber, and Robert E. Gross to return to Children’s Hospital in Boston, where he and Dr. Stella Van Praagh (married in 1962, with 3 children by 1965) founded and built the Cardiac Registry. This cardiac pathology laboratory, from its inception, was an integral part of the Departments of Pathology, Cardiology, and Cardiac Surgery. Consequently, personnel from all three Departments felt "at home" in the Cardiac Registry. Clinico-pathologico-embryologic correlation was facilitated by the fact that Drs. Richard and Stella Van Praagh were trained in pediatrics, pediatric cardiology, pathology and embryology.

During the past 37 years (1965-2002), Richard and Stella Van Praagh and colleagues have authored more than 270 publications. They developed the segmental approach to the diagnosis of congenital heart disease that is now used, with or without modification, worldwide. In addition to clarifying the pathologic anatomy, morphogenesis, diagnosis, and management of many specific forms of congenital heart disease, they described more than a dozen previously unknown cardiac anomalies:

1. isolated ventricular inversion { S,L,S }, in 1966;
2. anatomically corrected malposition of the great arteries, in 1967;
3. persistent fifth aortic arch, in 1969;
4. a new type of truncus arteriosus with two semilunar valves, aortic valvar atresia, and an intact ventricular septum, with L.F. Swift, M.D., in 1969;
5. transposition of the great arteries with posterior aorta, with Manuel Quero, M.D., of Madrid, in 1969 and 1971;
6. double-outlet left ventricle with intact ventricular septum with Milton Paul, M.D., of Chicago in 1970;
7. double-outlet right ventricle in which the only outlet from the left ventricle was a restrictively small left ventricular-to-right atrial shunt, with A. Megarity M.D., in 1972;
8. multiple previously unknown anatomic types of double-outlet left ventricle, with Paul M. Weinberg, M.D., in 1977;
9. a newly recognized form of congenital mitral stenosis in which the mitral orifice is subdivided by a muscular pillar, with Roger Ruckman, M.D., in 1978;
10. double-outlet right atrium, with Jorge Büchler, M.D. of Saõ Paulo, Brazil, in which there were a right atrial-to-right ventricular valve, a right atrial-to-left ventricular valve, and a left atrial to left ventricular (mitral) valve, i.e., three atrioventricular valves, in 1980;
11. a newly recognized form of tetralogy with isolated infundibuloarterial inversion, i.e., {S,D,I} , with Ronald B. Foran, M.D., in 1988;
12. two previously unknown anatomic types of atrioventricular discondance with ventriculoarterial concordance, with Luciano Pasquini, M.D. of Rome, in 1988; and
13. asplenia syndrome with aortic atresia with isolation of the innominate artery (which arises from the pulmonary artery via a patent ductus arteriosus) with John Papagiannis, M.D. of Athens, Greece.

Drs. Richard and Stella Van Praagh have also described five new surgical operations:

1. a new operation for interruption of the aortic arch, with William F. Bernhard, M.D., in 1971;
2. enlargement of a restrictively small ventricular septal defect in double-outlet right ventricle, with Dr Pierre Grondin and his colleagues in Montreal, in 1971;
3. a new operation for totally anomalous pulmonary venous connection to the coronary sinus, with Robert E. Gross, M.D., in 1972;
4. a new surgical approach to the resection of the conal septum (from above and from below) to facilitate intraventricular rerouting for the correction of double-outlet right ventricle, with Aram Smolinsky, M.D. of Tel Aviv, Israel and Aldo Castaneda, M.D. of Boston, MA in 1985; and
5. surgical closure of apical muscular ventricular septal defects via a right ventricular apical infundibulotomy, with Giovanni Stellin, M.D. of Padua, Italy and with John E,.Mayer, Jr., M.D. of Boston, in 2000 and 2002.