Dr. Andreas Gruentzig
“I don’t know how anyone can do these procedures without measuring pressures!”
That’s what Andreas Gruentzig, the father of coronary angioplasty, said to me back in 1985. He knew that looking at the angiogram alone was not sufficient for judging the blockage in an artery. Integral to the design of his technological breakthrough, the double-lumen angioplasty balloon, was a feature which allowed him to measure the blood pressure at either end of the arterial blockage. At the start of the procedure, he could quantify how significant the blockage was; when he was done inflating the balloon, he could see the benefit of the dilatation. The post-angiogram might look good, but the pressures sometimes signaled that blood flow through the area was not. So, inflate again. And maybe again. OK, pressure now looks good, we’re done! Pretty simple. Not brain surgery. Continue reading
Dr. Charles Dotter in LIFE Magazine (1964)
Crazy Charlie. An August 1964 LIFE magazine photo spread on Dr. Charles Dotter reinforced that nickname, given to Dotter by the vascular surgeons who knew him and his work at Oregon Health Sciences University in Portland — and who did not like what he was doing. Unblocking arteries in the leg without surgery? From the inside, using catheters? Crazy!
So that was 50 years ago, and to call Dotter a visionary is a vast understatement because this week, radiologists, cardiologists and surgeons have gathered in Las Vegas, not to gamble (although who’s to say…) but to present and hear the latest information, late-breaking trials and reports on vascular interventional therapies at the VIVA 14 meeting and see demonstrations of an array of devices and techniques. Continue reading
November 4 begins the 14th Annual VIVA meeting in Las Vegas. Yes, that’s “Viva, Las Vegas!”
The whole field of endovascular repair and intervention has grown exponentially since the first VIVA meetings. For example, the first endovascular repair of an abdominal aortic aneurysm was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical devices and dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year’s VIVA meeting. Continue reading
Charles Dotter. MD
It was 50 years ago today that Dr. Charles T. Dotter, a radiologist in Portland, Oregon, performed the first angioplasty. But it wasn’t in the heart; it was in the leg.
An 82-year-old woman was suffering from great pain in her left foot because of blocked circulation in her leg. Her toes had become gangrenous and there was an non-healing ulcer. Amputation was recommended by the physicians at Oregon Health Sciences University, but the woman refused.
Luckily, the surgeon in charge of the case knew of Dr. Dotter’s interest in the possibility of using a catheter to open a blocked artery. Continue reading
A recent New York Times article delves into a topic not often discussed: the fact that some surgeons are more skilled than others. “A Vital Measure: Your Surgeon’s Skill” by Dr. Pauline W. Chen is a fascinating look at a taboo topic. Dr. Chen describes an innovative program where a group of expert surgeons judges how skilled a particular colleague is by looking at a close-up videotape of how he or she works with their hands, utilizes equipment, and so on. How can you tell if a surgeon is on his game? As famed sports commentator Warner Wolf would say in his catch-phrase, “Let’s Go to the Videotape!”
Video control room in an early angioplasty live demonstration course
However, watching procedures on video is nothing new to me, or to any member of the interventional cardiology community. The field of angioplasty started on Day One with live demonstration courses where procedures were performed utilizing live TV broadcasts (see my video at the bottom of this post). I designed and directed many of these early courses and we focused cameras on the operator’s hands, very similar to the videos in Dr. Chen’s article. And just last week at the TCT 2013 Annual Symposium, thousands of cardiologists watched the hands of their colleagues in HD video on a 100 foot screen, being broadcast from Germany, or South Korea, or New York. Continue reading
Andreas R. Gruentzig, MD
On Tuesday morning the Transcatheter Cardiovascular Therapeutics (TCT) 2013 Conference celebrated the “father of angioplasty,” Dr. Andreas Roland Gruentzig, with the Career Achievement Award. Gruentzig, who died in 1985, was honored with a very moving tribute, which included a video, remembrances from his colleagues, and by the presence of his wife and two daughters, who were flown in from Zurich and Berlin by the TCT to receive the award on his behalf. Continue reading
I was alerted via Twitter today by @David_Dobbs (also retweeted by @matthewherper and @cardiobrief et al) that the Macy’s department store, formerly Foley’s, in Houston, Texas was demolished yesterday.
The building, as Dobbs explains in his blog post, “Slow-Mo Demo of Building Packed With Surgical & Personal History,” has personal significance for him, but also significance for the world of medicine. Foley’s is where Michael DeBakey purchased a bit of Dacron fabric, which he fashioned into an arterial graft to repair an aortic aneurysm, an achievement which gave birth to the wide spectrum of medical devices we have today.
A few years back, I made a documentary, tracing the history of these devices and below is a clip in which Dr. Michael DeBakey tells how his mother was really a critical element in this momentous medical advance.
You should also check out the video of the demolition itself in David Dobbs’ post.