He is considered one of the heroes of Argentine and international cardiovascular history. The medical procedure marked a turning point in modern health, as it saved, and still does, thousands of people around the planet.
When talking about the history of cardiology, the figure of René Gerónimo Favaloro is indissoluble. Even more so when it focuses on Argentina. The fact is that his invention, coronary revascularization or by-pass surgery, managed to save, and still does, millions of lives throughout the planet. Today, this so-called hero of international medicine would turn 101 years old and this legacy has already managed to exceed 57.
Summarizing Favaloro’s story in a single paragraph could become an injustice, since from his birth on July 12, 1923 in the El Mondongo neighborhood of La Plata, until the performance of the first aortocoronary bypass on May 9, 1967, It was 44 years of searching and perfecting. After 12 years of working as a doctor in Jacinto Arauz, a town in the Pampas, he decided to leave Argentina to travel, in 1962, to the United States. His goal is to specialize in cardiovascular surgery.
With this in mind, he completed an internship at the prestigious Cleveland Clinic under the tutelage of the renowned Donald Effler and focused on analyzing coronary angiography and studying the anatomy of the coronary arteries and their relationship with the heart muscle. The laboratory of Mason Sones, father of coronary arteriography, had the most important collection in the United States.
His objective was clear: learn about arterial anatomy. After 5 years of hard work that led him to perform an intervention that revolutionized the history of medicine when he performed the first coronary bypass in the world, on a 51-year-old woman.
However, far from seeking to achieve laurels, Favaloro recognized the previous path and stated: “Advances in medicine are always the result of many efforts accumulated over the years.” Next step, he warned who developed the advances that allowed him to reach this innovative intervention that was considered one of the “400 most important inventions in the history of humanity”, by the Google cultural platform, and the salvation for thousands of people. Worldwide.
Despite these achievements recognized by the international scientific community, Favaloro assured that “the ‘we’ was always above the ‘I’”, which is why he warned: “I never received distinctions in a personal capacity.” That is why, after this achievement, he received hundreds of doctors who, from all over the planet, traveled to the United States to learn about this innovative technique. “I would like to be remembered as a teacher more than as a surgeon,” he even stated. Fact that he carried out until his death, on July 29, 2000.
The history of the first coronary bypass
Like everything in Favaloro’s life, before he can immerse himself in the method, there is a story behind it. At the beginning of 1967, the possibility of using the saphenous vein in coronary surgery was raised for the first time. But he was not yet ready to put it into practice when, on May 9, 1967, he operated on this woman who, at that time, was 51 years old.
As warned by the Argentine Society of Cardiology in an article published 50 years after this intervention, “Favaloro planned to operate on the patient using the endarterectomy technique with graft, but since the segment turned out to be unusable, he decided to use the autologous saphenous vein interposed with the right coronary artery, and made the anastomosis to the aorta. The occurrence of it changed the history of Cardiology.”
These words, which are highly complex for all those who are not immersed in the technical language of doctors, can be roughly summarized as: when preparing to perform a graft to treat a coronary narrowing, it turned out that this portion of tissue was unusable. So, what he hypothesized and that had been achieved in animal models, became the solution.
Later, not only was the woman’s recovery exceptional, but her intervention also allowed her to live many more years. The next step was to standardize this method, which he called bypass or myocardial revascularization surgery. This decision boosted its international recognition and irreversibly changed the history of modern medicine, as it made its knowledge available to humanity.
What is and how is the coronary bypass invented by René Favaloro performed?
Beyond the story, the truth is that this technique is a special treatment for coronary artery disease, a pathology that causes a decrease in blood flow that transports blood to the heart muscle. Since these arteries are considered “the most important of the heart.” That is why coronary bypass works as a kind of “bridge” that allows this interruption or decrease to be overcome thanks to the use of other healthy blood vessels in the body, improving blood flow to the heart muscle.
The blood vessels used are generally from the chest, arm, or leg area. In the first case, the chosen one is the internal mammary artery, in the second it is the radial artery and in the last it is the saphenous vein. Although this procedure “does not cure the heart disease that caused the blockage, such as atherosclerosis or coronary artery disease, it can reduce symptoms, such as chest pain and shortness of breath,” the Mayo Clinic warns.
It is worth noting that this procedure is performed with an open heart, so there are risks inherent to its performance. It is for this reason that those who perform these interventions are surgeons specialized in cardiology.
The operation usually takes about 3 to 6 hours, although “the duration of the surgery will depend on the number of arteries that are blocked,” indicated from the Mayo Clinic. The intervention consists of an incision in the center of the chest, along the sternum. “Next, he will open the rib cage to reveal the heart. Once the chest is opened, the heart will be temporarily stopped with medication and the heart-lung machine will be turned on,” they indicated.
The next step is to remove that healthy blood vessel, which is called a graft, and then join the ends below the blocked heart artery, creating this bridge that allows blood to circulate outside the obstruction.
After performing this procedure, “the heartbeat is restored in the operating room, the extracorporeal circulation machine is stopped and the sternum is closed with a wire to allow the bone to heal,” they listed from the Mayo Clinic. Finally, recovery time extends between 6 and 12 weeks.
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