Designatory Letters: 
MB St And 1929 FRCS Edin 1932, FRCS Eng 1934, FRCP Edin 1964

Contributed by Arthur Kitchin

The death of Andrew Logan at the age of 98 recalls the early days of cardiothoracic surgery in Edinburgh in the decades after the second World War. Born: on a farm in Fife he took an arts degree at St Andrews before studying medicine and undergoing junior surgical training at Newcastle. After the war during which he was an army surgeon in North Africa he was appointed to Edinburgh in 1948 to set up a unit for thoracic and cardiac surgery. At this time rheumatic fever was prevalent with its sequel of progressive damage to the heart valves, particularly the mitral and many young and middle-aged patients died from unrelieved congestion of the lungs. Many surgical attempts to widen the narrowed valve had met with little success when in 1955 Logan pioneered the use of a mechanical dilator introduced through the left ventricle and opened in the orifice of the valve, a manoeuvre requiring skill and judgment. the results published by Logan and his physician colleague Richard Turner in 1959 led to the technique being generally adopted, at least until the advent of cardiopulmonary bypass made open heart surgery and valve replacement possible.

Logan led a fine surgical team backed up by anaesthetists technical and nursing staff. An important factor in their success was the weekly medical-surgical conferences at which the clinical details and data of patients being assessed for operation were reviewed and discussed. In these days accurate diagnosis depended largely on the minutiae of clinical and particularly auscultatory findings. These case conferences together with subsequent review of outcomes were an important learning experience for all concerned.

Logan retired in 1972 by which time open heart surgery was established leading to definitive treatment of many congenital anomalies and also coronary artery disease. He then spent several years in Durban working with his former senior registrar, Professor le Roux. With his staff he always insisted on high standards but his air of quiet authority was tempered by a genial equanimity. Off duty he had a wide interest in literature, the arts and the Scottish countryside. In his last difficult years of blindness and poor mobility he retained his love of good humoured and stimulating conversation.