Advances in Coronary Surgery

The first successful aortocoronary bypass operation was periormed in 1964 by Garrett, Howell, and DeBakey in Houston.26 That same year, Kolesov in Leningrad performed the first planned anastomosis between the left internal thoracic artery and the left anterior descending artery. 27 The future development of coronary angiography, cardiopulmonary bypass and cardioplegia helped coronary bypass surgery evolve from these first seminal events, and by the mid 1980s, coronary revascularization using cardiopulmonary bypass had become an accepted technique with durable outcomes.

In July of 1979, Andreas Gruentzig launched the era of percutaneous coronary intervention (PCI) with the development of percutaneous transluminal coronary angioplasty. 28 Although outcomes were not as durable, the difference in morbidity and mortality made it an attractive alternative to surgery. The development of stent technology improved outcomes, and the introduction of drug-eluting stents in the new millennium dramatically reduced in-stent restenosis. As coronary bypass surgery continues to be refined, the challenge is to minimize the morbidity and mortality while preserving the proven durability of surgical revascularization.