Images in Clinical Medicine
Tribute to a Master's Work — A 24-Year Follow-up
N Engl J Med 2004; 351:1332September 23, 2004
- Article
In April 1978, Dr. Andreas Grüntzig, of University Hospital, Zurich, told a patient who had a tightly narrowed left anterior descending coronary artery that he did not have enough experience to cite an accurate success rate for balloon angioplasty of this artery before he performed the procedure. He said that the patient was only his eighth, and his first from the United States, to undergo this procedure. Panel A shows the angiogram from 1978. The left-hand image shows a lesion in the proximal left anterior descending coronary artery (arrow), the middle image shows the balloon inflation, and the right-hand image shows the result after the balloon angioplasty, with minimal residual stenosis (arrow). For the next 24 years, the patient enjoyed excellent health and remained physically very active. In April 2002, he presented with an acute myocardial infarction of the inferior wall. Angiography showed total occlusion of the right coronary artery (Panel B, left-hand image, arrow); two severe lesions, including the total occlusion, were successfully stented (Panel B, middle and right-hand images, arrows). Amazingly, the left anterior descending coronary artery was patent, with no recurrence of disease (Panel C, arrows). The patient is now 76 years old.
Samir R. Kapadia, M.D.
Cleveland Clinic Foundation, Cleveland, OH 44195Maria Schlumpf, B.S.
University Hospital, Zurich 8006, Switzerland
