Wednesday, January 9, 2008

Inventor of cardiac bypass (CABG) - brilliant mind and outstanding surgeon - and yet he committed suicide at 77

Cleveland Clinic has been the site of numerous medical firsts, among them:

- invention of “artificial kidney” dialysis machine
- first coronary catheterization by Mason Sones in 1958
- first coronary bypass surgery (CABG) by Rene Favaloro in 1967

Several Cleveland hospitals have what I call "history corridors" with photos of historic events and people on the walls. Cleveland Clinic has one on the 9th cardiology floor illustrated with photos of physicians and scientists who made the Clinic what it is now -- the number one hospital in cardiology for 13 years in a row. Among the faces on the wall, one can recognize Mason Sones who performed the first coronary catheterization, Rene Favaloro who did the first coronary bypass surgery, our former CEO Floyd Loop who first used the internal mammary artery for CABG, our current CEO Toby Cosgrove, Eric Topol, Andrea Natale, and Steven Nissen. The same "history corridor" is featured at the Cleveland Hopkins airport. I have met Toby Cosgrove on 2-3 occasions but never knew he had overcome his dyslexia to become one of the world's most renowned cardiac surgeons, an inventor with 19 patents, who used to perform 700 surgeries per year. Remarkable.

Following the links from the Wikipedia entry about Cleveland Clinic, I was surprised to learn how the life of the inventor of the CABG, Rene Favaloro, had developed. Life is truly stranger than fiction:

"Dr. René Gerónimo Favaloro (July 14, 1923 – July 29, 2000) was an Argentine cardiac surgeon who created the technique for coronary bypass surgery in 1967.

In Argentina, as a small town rural physician, he read about developments in cardiovascular interventions, and developed an enthusiasm for thoracic surgery. At one visit to La Plata, he met Professor Mainetti, who pointed him in the direction of the Cleveland Clinic.

With few resources and some rudimentary English, he decided to travel to Cleveland. He first worked as a resident and later on as a member of the surgery team, working with Donald B. Effler, head of cardiovascular surgery, F. Mason Sones, Jr., who was in charge of the Angiography Laboratory and William L. Proudfit, head of the Department of Cardiology.

Every day, having hardly finished working in the surgery room, Favaloro would spend hours upon hours reviewing coronary angiograms and studying coronary arteries and their relation with the cardiac muscle. The Laboratory of Sones, father of the coronary arteriography, had the most important collection of angiograms in the United States.

At the beginning of 1967, Favaloro began to consider the possibility of using the saphenous vein in coronary surgery. On May 9, 1967, Dr Favaloro performed the first documented saphenous aortocoronary bypass in a 51-year-old woman who had total occlusion of the proximal third of the right coronary artery.

Four years later, in 1971 Favaloro, returned to Argentina with the dream of developing a center of excellence similar to the Cleveland Clinic, that combined medical attention, investigation and education.

Bearing that in mind he founded the Fundación Favaloro in 1975 along with other collaborators. He took great pride in having trained more than 450 residents from all over Argentina and the Americas.

By the year 2000, Argentina was already submerged in an economic and political crisis, and the Favaloro Foundation US$ 75 million in debt. Favaloro requested the government to pay its debts to the Foundation on repeated occasions without receiving an official response. On July 29 of that year, Favaloro took the tragic decision of committing suicide; in bitter irony, shooting himself in the heart. He was 77."

High-risk profession: Suicide rate of U.S. doctors is one per day http://goo.gl/oJMH



The Gift of Time is a short film about the doctors at the Cleveland Clinic.

References:
René Favaloro from Wikipedia, the free encyclopedia.
Rene G. Favaloro, MD: The Passing of a Pioneer. Circulation. 2001;103:480.
In Memoriam: Tribute to René Favaloro, Pioneer of Coronary Bypass. Tex Heart Inst J. 2000; 27(3): 231–232.
High Achieving Dyslexics: Toby Cosgrove. I Speak of Dreams, 2004.
Toby Cosgrove in Cleveland Clinic Magazine, 2004 9 (PDF).
The First Coronary Artery Bypass was done by a rural doctor from Argentina who wanted to learn from Cleveland Clinic's famed surgeons http://goo.gl/hxChe
Image source: Wikipedia.

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