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Ann Thorac Surg 2005;79:S2221-S2227
© 2005 The Society of Thoracic Surgeons

Supplement

Coronary Artery Surgery

Floyd D. Loop, MD*

Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio

Accepted for publication February 21, 2005.

* Address reprint requests to Dr Loop, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH44106 (E-mail: fdl@ccf.org).

Presented at the 4th Annual Lillehei Heart Institute Symposium Celebrating the 50th Anniversary of Open-Heart Surgery by Cross Circulation, Minneapolis, MN, Oct 19–20, 2004.

The first 300 words of the full text of this article appear below.


   Introduction
 
The history of coronary artery surgery has taken place across a continuum of discovery spanning more than 40 years, involving hundreds of physicians and scientists, and thousands of scientific studies. During this time, surgical techniques evolved through a labyrinth of success and failure (Fig 1). A generation of pioneering cardiothoracic surgeons established the efficacy of venous and arterial bypass grafts and refined patient selection. By the 1980s, coronary artery surgery was one of the most commonly performed major surgeries on earth, and excellent results had become routine.


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  		Fig 1. Evolution of coronary artery surgery. This maze indicates significant events in the evolution of coronary artery surgery. The major discoveries of extracorporeal circulation and coronary arteriography enabled coronary artery bypass to be performed with improving rates of success. (CABG = coronary artery bypass grafting; IMA = internal mammary artery; OPCAB = off-pump coronary artery bypass grafting.)

 
The pathway that eventually led to the development of coronary artery surgery began in 1902, with the work of Alexis Carrell, whose experiments in blood vessel anastomoses earned him the Nobel Prize in 1912. As early as the 1930s, surgeons were attempting myocardial revascularization by means of talc poudrage and omentopexy. Internal mammary ligation and implants were also tried. But modern cardiac surgery could not become a practical reality until the mid-20th century, with the development of the pump oxygenator and selective cine-coronary arteriography.

The coronary arteriogram was the serendipitous discovery of Frank Mason Sones, a pediatric cardiologist at The Cleveland Clinic. In 1957, he was the first to combine cardiac catheterization with high-speed x-ray motion picture photography. During the next 4 years, he and Earl Shirey performed arteriograms in 1,000 patients, reporting their results in 1962 [1], and effectively launching the modern era of coronary artery surgery.

In the early 1960s, . . . [Full Text of this Article]






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