CABG at 50 (or 107?) — The Complex Course of Therapeutic Innovation

Anniversaries offer opportunities to commemorate crucial discoveries of modern medicine, such as vaccination (May 14, 1796), ether (October 16, 1846), and insulin (January 11, 1922). But zeroing in on specific dates can obscure important dynamics. Innovation in medicine is a complex and continuous process that generally can’t be pinned down to a single moment in time.

The history of coronary-artery bypass grafting (CABG) demonstrates the subtleties of medical innovation well. Fifty years ago, on May 9, 1967, Cleveland Clinic surgeon René Favaloro performed his first CABG procedure. By 1970, he and his colleagues — who are often credited with having “revolutionized the treatment of ischemic heart disease”— had performed more than 1000 such operations. Impressed by their results, surgeons throughout the United States adopted the technique. But although Favaloro’s work popularized CABG, he was not the first to perform the operation. Moreover, he quickly modified his initial approach, and surgeons have been continually modifying the operation ever since. CABG, like all significant medical interventions, is the product of innumerable innovations by many physicians.