This story reminds me of a live case during a PTCA course that I attended as a young interventional cardiologist in Lausanne early in the eighties. The case went awfully wrong, live transmission was cut and we all believed that the patient was sent urgently to the cardiac surgeon. However, one hour later we were again connected to cathlab and Ulrig Sigwart told us that the patient was fine and was readied to bring her back to her room after the insertion of a new intracoronary device that fixed the ugly dissection flaps that were induced by balloon angioplasty. I do not recall if he already used the word stent but it was one of the first stents implanted in man.

Some years later I was invited to a meeting with Patrick Serruys in Eindhoven were he proposed to participate to the BENESTENT trial. I hesitated and did not participate to the study since at that time I believed that interventional cardiologists should not be sorcerer’s apprentices and should not put a stent in every lesion if you already had an excellent result after plain balloon angioplasty. It turned out that I was wrong.

Indeed we owe a lot to the founding fathers of interventional cardiology who showed us the direction and paved the way to point where are now.

Christian JM Vrints MD PhD FESC FACC

professor of Medicine and Cardiology
University of Antwerp

Belgium

Christian,

Thanks so much for sharing your remembrances of the "early days" of pci.  A patient in our practice was the first in Kentucky to receive a stent. How curious a thing it was.  We didn't know quite what to expect.

 We owe a lot to those interventionalists  in our pci centers that continued to expand on the early experiences of the pioneers.  My mentor , the late Dr. Ron Masden, spent his life in a dark room, threading wires across impossible lesions.  He was often chastised for doing more than one vessel!! I know he would have been at the TCT meeting and would have especially loved to hear what is on the horizon with Xcience, Catania, etc. 

Appreciate your post.

Melissa

Dear Melissa

For those of us who have been practicing the art and science of Interventional Cardiology for the past quarter of a century remember the early innovative days of PCI with awe and nostalgia. Emergence and progression of this new specialty has been chronicled by David Monagan and David O Williams, MD in the book, "Journey into the Heart" published by Gotham Books, 2007. I enjoyed reading about the pioneers in this field and their sometimes quirky and sometimes hauting but always interesting accounts of their personal and professional lives.  Starting with the chain-smoking, obscenities-spewing but lovable F. Mason Sones of the Cleveland Clinic where an accidental slippage of the catheter into the right coronoary artery  during an attempted aortic root injection gave birth to selective coronary arteriography. Charles Dotter of Oregon was an eccentric man who tinkered with wires and catheters and pioneered peripheral vascular dilatations with progressively increasing sizes of catheters-- "dottering". Melvin JUdkins of Oregon--a colleague of Dotter shaped catheters for selective injection of coronary arteries via the femoral approach. Coronary artery bypass was pioneered by Rene Favoloro in the 1960s. A workable heart lung machine was the result of hard work by C. WAlton Lillehei in Minnesota.

 Enter the swash-buckling and impressive, Andreas Gruentzig, an East German refugee with no formal training in cardiogy who quickly became the father of interventional cardiology. His rise in the medical circles was meteoric. Wooed by Spencer KIng and J.Willis Hurst, he was appointed at the prestigious Emory University and conducted his famous training courses there. GeofferyHartzler- the flash from kansas,  who performed the first PCI in an MI setting and showed extreme dexterity in reaching the far ends of coronories with his balloon catheter. He mesmerized his attendees at his courses. Introduction of some very cumbersome PCI procedures including, rotablation, atherectomy with their gradual exit from the stage is very intersting.  Stories of Swan-Ganz catheter, interventional electrophysiogy  and innovations in pacemakers and defibrillators are all extremely exciting. Stents have revolutionized the specialty and with their use, the specter of "acute closure'-- the dreaded complication of POBA,  has completely disappeared.

I worked with the late Ron Masden as well who, as you pointed out, was fearless and worked tirelessly in the interventional cardiology field. I was lucky to attend Gruentzig and Hartzler courses and am gratified at the maturation of a tremendously exciting specialty.

Regards Saleem

Saleem,

So sorry I missed your post.  I had to take a friend of our family  to Duke to try and get on an experiemental  chemo protocol and then the AHA, all the while trying to work in between. 

GREAT navigation through the history of PCI and other interventional developments.  I really enjoyed reading it and learned a lot too as I always do when we see each other!

I cannot tell you how much I miss Ron Masden.  For about 13 years, almost every Friday afternoon, he would call me with a run down of all the patients I'd referred to him.  During 2-3 Christmas Holidays, my secretary would come and get me out of a room and tell me there was someone there to see me.  When I would go to the front, there he would stand, gifts in both hands, fruit baskets, etc.  in his long wool  winter  coat. He had driven to clinic in Tompkinsville and then over the 40 miles to Glasgow.   It was odd to see him in the light of day without scrubs.  He was always suprisingly thinner and taller than I could remember because I rarely saw him without lead and scrubs. His gray hair always accentuated his pallor induced by a compete lack of sun exposure over the past 30 years.    He was smiling as I walked toward him, like he had a present for his mom, even though he was 20 years my senior and that last picture of him on that last holiday is in indelible postcard in my mind's eye. 

I am still hurt that he did not ever mention to me he was having difficulties of any type.  If only he had asked any of us, we could have probably steered him through it and away from trouble.  I think cardiologists should never treat themselves. I cannot tell you how many tears were shed on all of our behalf here as I'm sure there were in Louisville.  

Saleem, so glad to reminisce with you. Always appreciate your participation here on theheart.org. Hope to see you soon.

Melissa  

Melissa

It is my turn to apologize for being tardy in checking your post. Thanks very much for your kind words. I have the utmost admiration and respect for you for your extremely exhaustive coverage of cardiology meetings and keeping us abreast of all the pertinent trial results. Your anecdotal and personal descriptions about the real patients are always welcome as well.

Ron masden was a wonderful senior colleague who was my mentor as well and I scrubbed with him on numerous occasions for interventional procedures on my own patients. I was completely unaware of his ailment as well. I did write an "In Memoriam" piece about him in Louisville Medicine and I was honored to have received a kind note from his widow afterward.

Keep up the good work!!  And may be one of these days, I might finally see you again in Glasgow, Ky. The last two times, we had not been able to connect.

Best Regards

Saleem

Saleem,

And I shall look forward to it as well! Thanks so much for your kind words and your post!

Melissa