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Canadian Journal of Cardiology

Forty Years of Innovations: The Past, Present, and Future of Interventional Cardiology

      On the cloudy morning of February 13, 1980, Dr Paul-Robert David performed the first percutaneous coronary intervention (PCI) in Canada at the Montréal Heart Institute (Fig. 1). The left anterior descending artery of a 35-year-old man suffering from stable angina was treated with 3 inflations of a Grüntzig balloon catheter with the use of a transfemoral approach, after which the stenosis decreased from 80% to 35%. He was discharged on postprocedure day 3, and follow-up coronary angiography performed 6, 18, and 40 months later showed that the stenosis further decreased down to 20%, 10%, and 0%, respectively. This was the first of many PCIs performed over the following 40 years, an unprecedented revolution in the practice of cardiology that ultimately benefitted millions of patients globally. Since then, PCI techniques, devices, and adjunctive therapies have sometimes improved slowly and iteratively, sometimes through spectacular revolutions. The daily practice of a contemporary interventional cardiologist has nothing to do with what it was even 2 decades ago, thanks to the work of a dedicated community of clinicians and researchers who joined efforts to develop innovations, test them in carefully crafted randomised trials, disseminate them, and implement them in their routine clinical practice (Fig. 2). To highlight these advances, pioneers, contemporary leaders in the field, and direct witnesses of these innovations have been brought together to produce a series of articles reviewing the past, present, and future of interventional cardiology in this special edition of the Canadian Journal of Cardiology.
      Figure thumbnail gr1
      Figure 1D. Paul-Robert David (centre) in the catheterisation laboratory of the Montréal Heart Institute, where he performed the first percutaneous coronary intervention in Canada in 1980. Provided by Dr. Gilbert Gosselin with permission from the Institut de Cardiologie de Montréal.
      Figure thumbnail gr2
      Figure 2The first transradial percutaneous intervention in the world was performed by Dr Lucien Campeau (left) at the Montréal Heart Institute.
      • Campeau L.
      Percutaneous radial artery approach for coronary angiography.
      In this picture, he is accompanied by his radiologist colleague Dr Jacques Lespérance (centre), and invasive cardiologist Dr Martial Bourassa (right), who developed the Bourassa coronary catheter. Provided by Dr Gilbert Gosselin with permission from the Institut de Cardiologie de Montréal.
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