Cardiac and vascular surgery: results, perspectives and hopes

Abstract

Despite the sporadic accumulation of knowledge about cardiovascular diseases beginning with antiquity, few advances were made in the development of effective treatment until several decades ago. As late as 1940, treatment was based primarily on indirect methods of increasing blood flow by vasodilation through drugs or sympathectomy [1]. At the turn of the century, extensive experimental studies demonstrated the feasibility of cardiac and renal transplants, as well as of excision of arterial segments and restoration of continuity by end-to-end anastomosis or by insertion of arterial grafts. To be sure, a few patients with aneurysms or peripheral arterial injuries were successfully treated in this way. In 1923, Leriche [2] described aorto-iliac occlusive atherosclerotic disease (Leriche’s syndrome) and predicted that excision of the diseased segment and its replacement with an aortic graft would be the ideal treatment for this condition. It was almost 30 years later, however, before this prediction became a reality when Oudot [3] performed the procedure for the first time (1951).