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J Thorac Cardiovasc Surg 2008;136:1117-1122
© 2008 The American Association for Thoracic Surgery

Editorial

Fifty years of cardiothoracic surgery through the looking glass and what the future holds

Marko Turina, MD*

University of Zurich, Zurich, Switzerland

Received for publication August 14, 2008; accepted for publication August 25, 2008.

* Address for reprints: Marko Turina, MD, University Hospital, Haldenbach 18, 8091 Zurich, Switzerland. (Email: marko.turina@usz.ch).

The first 300 words of the full text of this article appear below.

Those who cannot remember the past are condemned to repeat it.

George Santayana

I thank the Association and its President Craig Miller for the honor of inviting me to address the meeting. I will concentrate on the topic that captivated my interest for many years. Some of you might be skeptical about such a talk, and I do not blame you. We have all sat through the tedious ramblings of elderly surgeons, sometimes coupled with bad jokes, and hoped that their talk would not be too long.

I will try to show you that it is not only interesting but also important to study the history of our profession. One of the famous quotations by Spanish-born American philosopher George Santayana also holds true in our profession: "Those who cannot remember the past are condemned to repeat it." Forgotten facts can lead to problems in recent innovations, when previous experiences are disregarded by the younger generation. I will mention only 2 recent examples. Parasternal incision for minimally invasive approach to the aortic valve can result in a disturbing and difficult to treat lung herniation. The fact was well known in the 1960s and is only being rediscovered now. Equally important, a proximal coronary stenosis can develop when coronary arteries are cannulated for continuous coronary perfusion. This might cause intimal hyperplasia and lead—in the years after the first operation—to a potentially lethal left main stenosis. This fact was first published in 1976, and I am worried that the newly "rediscovered" method of beating heart valve replacement with direct coronary artery perfusion might lead to the same kind of late complications.

Another lesson from studying the history of our profession is a profound distrust of claim of primacy. It is generally difficult to present something as truly new, as a detailed description of . . . [Full Text of this Article]






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