Myocardial Revascularization Surgery: JACC Historical Breakthroughs in Perspective.

Coronary artery bypass grafting (CABG) was introduced in the 1960s as the first procedure for direct coronary artery revascularization and rapidly became one of the most common surgical procedures worldwide, with an overall total of more than 20 million operations performed. CABG continues to be the most common cardiac surgical procedure performed and has been one of the most carefully studied therapies. Best CABG techniques, optimal bypass conduits, and appropriate patient selection have been rigorously tested in landmark clinical trials, some of which have resolved controversy and most of which have stoked further debate and trials. The evolution of CABG cannot be properly portrayed without presenting it in the context of the parallel development of percutaneous coronary intervention. In this Historical Perspective, we a provide a broad overview of the history of coronary revascularization with a focus on the foundations, evolution, best evidence, and future directions of CABG.

Hybrid Coronary Revascularization: Perspective Current State After 25 Years of Start.

Hybrid coronary revascularization (HCR) represents a minimally invasive revascularization strategy in which the durability of the internal mammary artery to the left anterior descending artery graft is combined with percutaneous coronary intervention to treat remaining lesions. It first was introduced in the mid-1990s and aspired to bring together the "best of both worlds" - the excellent patency rates and survival benefits associated with the durable left internal mammary artery graft to the left anterior descending artery alongside the good patency rates of drug-eluting stents, which outlive saphenous vein grafts to non-left anterior descending vessels. Although in theory this is a very attractive revascularization strategy, several years later, only small randomized controlled trials comparing HCR with coronary artery bypass grafting has recently emerged in the medical literature, raising concerns regarding HCR's role. In the current review, we discuss HCR's rationale, the current evidence behind it, its limitations, and procedural challenges.

The evolution of coronary stents.

INTRODUCTION: Percutaneous coronary intervention (PCI) is 40 years old this year. From its humble beginnings of experimental work, PCI has transitioned over years with coronary artery stenting now a standard medical procedure performed throughout the world. Areas covered: The conversion from plain old balloon angioplasty (POBA) to the present era of drug eluting stents (DES) has been driven by many technological advances and large bodies of clinical trial evidence. The journey to present day practice has seen many setbacks, such as acute vessel closure with POBA; rates of instant restenosis with bare metal stents (BMS) and more recently, high rates of stent thrombosis with bioabsorbable platforms. This work discusses POBA, why there was a need for BMS, the use of inhibiting drugs to create 1st generation DES, the change of components to 2nd generation DES, the use of absorbable drug reservoirs and platforms, and possible future directions with Prohealing Endothelial Progenitor Cell Capture Stents. Expert commentary: This paper reviews the evolution from the original pioneering work to modern day practice, highlighting landmark trials that changed practice. Modern day contemporary practice is now very safe based on the latest drug eluting stents and supported by large datasets.

The History of Primary Angioplasty and Stenting for Acute Myocardial Infarction.

The evolution of the management of acute myocardial infarction (MI) has been one of the crowning achievements of modern medicine. At the turn of the twentieth century, MI was an often-fatal condition. Prolonged bed rest served as the principal treatment modality. Over the past century, insights into the pathophysiology of MI revolutionized approaches to management, with the sequential use of surgical coronary artery revascularization, thrombolytic therapy, and percutaneous coronary intervention (PCI) with primary coronary angioplasty, and placement of intracoronary stents. The benefits of prompt revascularization inspired systems of care to provide rapid access to PCI. This review provides a historical context for our current approach to primary PCI for acute MI.

Myocardial revascularization by percutaneous coronary intervention: past, present, and the future.

Percutaneous coronary revascularization was introduced over 30 years ago by Dr Andreas Grüntzig. This event catapulted adult invasive cardiology from a diagnostic entity to a therapeutic modality, which has since become the most frequently performed coronary revascularization procedure worldwide. This success has been built on several key concepts-problem identification, targeted solutions, applied technology, populations-based testing, postmarket surveillance, and education. These concepts will continue to be of paramount importance as novel percutaneous innovations and strategies are brought to bear on an increasingly broader group of patients with cardiovascular disease. In this review, we trace the history, review current practices, and also provide insight into future potential innovations, as it pertains to percutaneous coronary revascularization.

Cardiogenic shock: a historical perspective.

Significant progress has been made over the past 60 years in defining and recognizing cardiogenic shock (CS), and there have been tremendous advances in the care of patients who have this illness. Although there are many causes of this condition, acute myocardial infarction with loss of a large amount of functioning myocardium is the most frequent cause. It was recognized early in the study of CS that prompt diagnosis and rapid initiation of therapy could improve the prognosis, and this remains true today. Although the mortality from CS remains high, especially in elderly populations, modern therapies improve the chance of survival from this critical illness.

Vineberg operation: a review of the birth and impact of this surgical technique.

The Vineberg operation was introduced by Arthur Vineberg in the early 1940s as an experimental model for revascularization of ischemic cardiac tissue in animal models with direct implantation of left internal mammary artery into ventricular myocardium. The first attempt in a human was performed in 1950, followed by 10,000 to 15,000 Vineberg operations completed in the 1950s and 1960s until the birth of coronary artery bypass grafting. We report a historical perspective, birth and impact of this surgical technique, and possible implications for the future of cardiology and cardiac surgery.