The serendipitous discovery that visualization of the coronary arteries
was possible—and not lethal—was seized upon by Sone’s surgical
colleagues at the Cleveland Clinic, realizing that they “had the best
possible set-up for the surgical treatment in selected patients with
coronary artery disease.”^21 Indeed they did—and they do. Donald Effler,
then chief of cardiothoracic surgery, made good use of the new diagnostic
tool, performing the world’s first coronary artery operation in January
- This would be the bailiwick of the Cleveland Clinic till this day, and
more coronary artery bypass operations are performed there every year
than anywhere else in the world. Coronary artery bypass grafting (CABG)
was pioneered in Cleveland, and the technique of bypassing an area of
blockage with vein harvested from the leg was the work of René Favaloro,
an Argentinian surgeon on staff at the Cleveland Clinic. It is one of
mankind’s greatest operations, and is still performed today in every major
hospital around the globe, with modifications.
The Cleveland Clinic is a world leader in multiple fields, ranking at the
top of the list in multiple specialties, including most all surgical fields.
This is no accident—the CEO of the clinic has traditionally been a
surgeon, including the CEO at the time of this writing, Tomislav
Mihaljevic, a cardiothoracic surgeon. The modus operandi in Cleveland is
simply different than most hospitals, but it is no accident that some of the
greatest institutions in the world, like the Hospital for Special Surgery, are
also led by a surgeon.
Coronary artery bypass grafting was a decade old when the world’s first
angioplasty was performed in 1977 in Zurich, Switzerland, by Andreas
Gruentzig. The development of angioplasty, and later coronary stenting,
follows a typical path in medicine and surgery. Technological refinement
begins with crude interventions, transitioning to less invasive and more
sophisticated techniques, eventually leading to solutions that seemed
impossible only a few years before. The first selective imaging of a
coronary artery was in 1958, and less than twenty years later, angioplasty
was developed to open up a clogged artery with a tiny inflatable balloon,
followed shortly by the innovation of the cardiac stent in 1986.^22
In the New York Public Library, there is a small globe (five inches in
diameter) that is one of the earliest surviving cartographic spheres in
existence. It is made of copper, and if you position yourself over the land
mass of Asia, you can see the inscription, “Hic sunt dracones,” Latin for