The Birth, and Evolution, of Percutaneous Coronary Interventions

Dr Rutherford asks: When you first heard that Andreas Grüentzig had successfully performed a transluminal coronary dilation in September 1977, what were your thoughts?Did it seem a sustainable therapy at the time?Dr Serruys replies: In 1975 at a meeting in Frankfurt, a key opinion leader at that time, Professor Paul Lichtlen, Chief of Cardiology at Hannover, was describing during a keynote lecture a significant coronary lesion with a thin fibrous cap and a large atheromatous core; today, we call this a vulnerable plaque.He mentioned somewhat sarcastically that Dr Andreas Grüentzig had developed a procedure he believed could dilate that type of lesion.There was of course a lot of skepticism whether the procedure could be performed without major distal embolization.I went to see Andreas Grüentzig and to look at his poster.He had tied a ligature with catgut around the coronary artery of a dog, and he was using his balloon to open this artificial narrowing.Honestly, I could not foresee the future of this therapeutic approach.At that time, the Department of Cardiology in Zürich (where Grüentzig worked) was headed by 2 cardiologists, Hans Peter Krayenbühl and Wilhelm Rutishauser.Krayenbühl was not in favor of attempting the procedure, but Rutishauser was more enthusiastic about it.The famous Chief of Cardiovascular Surgery, Dr Åke Senning, told the Board of the hospital that he would help Andreas and be present in the cardiac catheterization laboratory to back up a potential catastrophe.The story is that when Andreas deflated the balloon and the gradient disappeared, Senning left the laboratory, without even looking at the angiogram, convinced the result was good.In 1978, Grüentzig reported successful dilation of an 85% left anterior descending coronary stenosis by PTCA in a 38-year-old man with severe angina and theThe Birth, and Evolution,