2007 James B. Herrick Award and Lecture—The Road Ahead

Abstract

The road ahead always starts from where it began. For the field of interventional cardiology, the road began 30 years ago this past September, when a 38-year-old physician treated a 38-year-old man for symptomatic coronary artery disease. After this “disruptive” experience, using “disruptive” technology, by a “disruptive” young physician, the landscape has never been the same. Andreas Gruentzig, that physician, revolutionized the practice of modern cardiovascular care, not just with the introduction of percutaneous transluminal coronary angioplasty, but even more with the concept that a person could work safely in an awake patient within a vascular tree to achieve a specific goal. This sentinel event spurred the development of an extensive family tree of discipline, including intravascular ultrasound; angioscopy; percutaneous treatment of structural heart disease, including among others valvular heart disease, hypertrophic obstructive cardiomyopathy, and atrial fibrillation; ablation; and treatment of carotid and peripheral arterial disease and, more recently, stroke. In addition, Dr Gruentzig can be said to have encouraged the development of less invasive surgical revascularization approaches, such as “mid-cab” coronary bypass graft surgery. Now that we have broken the barrier of working therapeutically within the vascular tree, the road ahead will include continual assignments and miniaturization of techniques for identification, prevention, and treatment of disease. That road ahead will only be limited by our ability to imagine and create and then our ability to document improved outcome for society, in both individuals and as a whole.