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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 Montreal Heart Institute (Figure 1). The left anterior descending artery of a 35-year old man suffering from stable angina was treated with three inflations of a Grüntzig balloon catheter using a transfemoral approach, after which the stenosis decreased from 80% to 35%. He was discharged on post-procedure day 3, and follow-up coronary angiograms 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 benefited millions of patients globally. Since then, PCI techniques, devices, and adjunctive therapy 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 two 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 randomized trials, disseminate them, and implement them in their routine clinical practice (Figure 2).
      Figure thumbnail gr1
      Figure 1Dr. Paul-Robert David (center) in the catheterization laboratory of the Montreal Heart Institute, where he performed the first percutaneous coronary intervention in Canada in 1980. Curtesy of Dr. Gilbert Gosselin.
      Figure thumbnail gr2
      Figure 2The first transradial percutaneous intervention in the world was performed by Dr. Lucien Campeau (left) at the Montreal Heart Institute.(12) In this picture, he is accompanied by his radiologist colleague Dr. Jacques Lespérance (center), and invasive cardiologist Dr. Martial Bourassa (right), who developed the Bourassa coronary catheter. Curtesy of Dr. Gilbert Gosselin.
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