JOURNEY INTO THE HEART

Science writer Monagan teams up with cardiologist Williams for an engaging and informative history of angioplasty.

With some two million now performed annually, this minimally invasive procedure has come to challenge bypass surgery in the world of cardiology. The central figure in its development was Andreas Gruentzig, a young German physician who performed the first coronary balloon angioplasty on a conscious human patient, at University Hospital in Zurich in 1977. But Gruentzig’s breakthrough depended on the earlier work of several others. Werner Forssmann, a young German surgical resident, proved in 1929 that a catheter could safely be inserted into a human heart by doing just that to himself. In 1958, Mason Sones of the Cleveland Clinic demonstrated that a contrast agent could be directly injected into a coronary artery, thus enabling doctors to view and photograph these arteries and any obstructions in them. University of Oregon radiologist Charles Dotter took the penultimate step in 1964, when he used multiple catheters of increasing size to open blocked arteries in the legs of patients, moving radiology from diagnostic imaging toward non-surgical intervention to treat vascular disease. Tinkering at his kitchen table, Gruentzig began attaching balloons to Dotter’s catheters, eventually coming up with the device that revolutionized cardiology. Gruentzig was soon persuaded to move to Emory University Hospital in Atlanta, where the colorful physician quickly became rich and acquired a large house, a private plane and a new wife. The authors show the reaction of open-heart surgeons to the introduction of this new, less-invasive procedure and blend into their narrative the complicated story of rivalries and machinations among the various manufacturers of the devices that made angioplasty possible.

Technical information presented with clarity makes this scientific narrative accessible to laypeople; up-close-and-personal portraits of the leading characters, assessing their private peccadilloes as well as their professional accomplishments, make it much fun to read.