Correspondence
The First Patient to Undergo Coronary Angioplasty — 23-Year Follow-up
N Engl J Med 2001; 344:144-145January 11, 2001
- Article
To the Editor:
Coronary angiography performed in a 38-year-old man on September 14, 1977, showed a high-grade but discrete stenosis of the proximal left anterior descending coronary artery just before the first large diagonal branch (Figure 1AFigure 1
Coronary Angiograms Obtained in a Patient before Coronary Angioplasty, in 1977 (Panel A), and in 2000 (Panel B).).1 The remainder of the coronary arteries and the left ventricle were normal.I told the patient that Dr. Andreas Gruentzig would offer him an alternative to bypass surgery. The alternative was coronary angioplasty. Gruentzig candidly explained the results that had been obtained in a few hundred patients treated with a balloon for peripheral-artery stenoses and mentioned the possibility of an immediate coronary bypass operation in case of problems. The patient consented without hesitation. Later, he stated that he instinctively trusted Gruentzig and hence his method.
The angioplasty procedure, performed on September 16, 1977, went well and eliminated the patient's symptoms.2 He quit smoking and soon stopped taking all his cardiac medications. On the 20th anniversary of the procedure, I convinced him to take acetylsalicylic acid and a statin for his slightly elevated cholesterol levels.
In 2000, at the age of 61, the patient had recurrent chest discomfort for the first time. It occurred at rest but not during exercise. He underwent coronary angiography on April 10, 2000. It revealed that the site that had been dilated earlier had normal patency (Figure 1B). There were only minor abnormalities elsewhere. The results of an exercise test the next day were clinically and electrocardiographically normal at a peak heart rate of 140 beats per minute and a blood pressure of 190/105 mm Hg.
Gruentzig and his wife died in an airplane crash on October 27, 1985. I do not believe Gruentzig would have dreamed that his first patient could remain free of recurrent symptoms of coronary artery disease for such a long time.
2 ReferencesBernhard Meier, M.D.
Swiss Cardiovascular Center Bern, CH-3010 Bern, Switzerland1
Gruentzig A . Results from coronary angioplasty and implications for the future. Am Heart J 1982;103:779-783
CrossRef | Web of Science | Medline2
Hurst JW . The first coronary angioplasty as described by Andreas Gruentzig. Am J Cardiol 1986;57:185-186
CrossRef | Web of Science | Medline
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