The first balloon angioplasty procedure on a coronary artery

In 1977 the first balloon angioplasty procedure on a coronary artery was performed in Zurich, Switzerland, by Andreas Gruentzig, a German-born physician. Building on the work of physician Charles Dotter, who had performed the first-ever angioplasty procedure in a leg artery over a decade earlier, Dr. Gruentzig began a revolution in the treatment of coronary artery disease.

By the 1970's, coronary artery bypass graft surgery (CABG) had become an accepted treatment method for coronary artery disease. Up until this time, cardiologists were concerned primarily with diagnosis and medical management of heart disease. The development and refinement of percutaneous transluminal coronary angioplasty (PTCA) in the 1980's brought about an exciting new dimension in the treatment of coronary artery disease (CAD).

In the late 1960's, Dr. Gruentzig first learned of the American Charles Dotter's angioplasty procedure at a lecture in Frankfurt, Germany. Encountering bureaucratic resistance in Germany to his exploration of angioplasty techniques, Dr. Gruentzig moved to Switzerland in 1969. He continued his work, developing balloons sturdy enough to compress lesions inside arteries and catheters capable of monitoring pressure, maintaining blood flow and passing fluid into the balloons for inflation, yet were small enough to pass into tiny coronary arteries. Dr. Gruentzig presented his initial findings at an American Heart Association meeting in 1975. Although most physicians were skeptical of Gruentzig's ideas of using balloon catheters to dilate coronary arteries, a few physicians were intrigued by the concept. With the support and assistance of American physician Richard Myler, the first coronary artery balloon angioplasties were performed in San Francisco by Drs. Gruentzig and Myler, using a direct method on patients already in the operating room and with chests opened for coronary artery bypass graft surgery. The procedures were successful.

The next step in accomplishing Dr. Gruentzig's goal of a percutaneous angioplasty procedure was to develop a catheter capable of being manipulated into tiny, curving coronary arteries. Once this task was completed, Dr. Gruentzig searched for and found an appropriate patient for the first percutaneous coronary artery balloon angioplasty procedure.

Following his successful first procedure, Dr. Gruentzig continued to perform and improve the technique, and taught it to physicians from around the world. However, frustrated with the bureaucratic limitations he felt were being placed on his career, Dr. Gruentzig began to look for an opportunity to move to the United States.

In 1980, Emory cardiologists Spencer King, III, John S. Douglas Jr. and Douglas C. Morris attended Dr. Gruentzig's PTCA course in Europe. Sitting with Dr. Gruentzig on a train after the course, they learned of Gruentzig's desire to immigrate to the United States. This casual conversation led to an all-out effort by Emory to bring Dr. Gruentzig to Atlanta. By late 1980, Dr. Gruentzig had become a faculty member in medicine and radiology at the Emory University School of Medicine, as well as the director of interventional cardiovascular medicine.

At Emory, Dr. Gruentzig continued his work to advance the knowledge and techniques of percutaneous transluminal coronary angioplasty and built the Emory program into a premiere interventional cardiology program. PTCA provided an alternative, less-invasive treatment option for coronary artery disease. Research has shown that PTCA is an effective treatment for CAD, with a similar success rate to that of coronary artery bypass graft surgery.

Unfortunately, Dr. Gruentzig did not live to see the research results on PTCA outcomes. In October of 1985, the airplane that he was piloting in stormy weather crashed near Macon, Georgia. Dr. Gruentzig was forty six at the time of his death.

Truly a leader in his field, Andreas Gruentzig began a revolution in the treatment of coronary artery disease, a revolution that continues to bring new concepts into reality as the battle against heart disease goes on. To honor and acknowledge Dr. Gruentzig's contributions and pioneering work in the field of cardiology, Emory established the Andreas Gruentzig Cardiovascular Center to further build upon Dr. Gruentzig's progress in the area of interventional cardiology.

A number of seminal contributions to this rapidly expanding field have been made by Emory cardiologists working in the Gruentzig Center. Among these are the development and, in 1987, the first human use of a coronary stent in this country, completion of a large randomized trial of angioplasty compared to surgery in patients with multiple coronary artery narrowings, and the initial human experience with Beta radiation in the prevention of restenosis (renarrowing) after coronary angioplasty.

Bio courtesy of Emory Healthcare.