Our surgical heritageRobert H. Goetz: the surgeon who performed the first successful clinical coronary artery bypass operation
Section snippets
Myocardial revascularization in the first half of the 20th century
On May 5, 1910, in a communication to the American Surgical Association, Alexis Carrel described the first experimental attempt of coronary artery bypass using a segment of the carotid artery. Carrel stated [1]:
Unfortunately, the operation was too slow. Three minutes after the interruption of the circulation fibrillatory contractions appeared but the anastomosis took five minutes. By massage of the heart, the dog was kept alive. But he died less than two hours afterwards. It shows that the
“My career was rather bumpy”
I asked Dr. Goetz for details of his biography. On April 20, 1999, Dr. Goetz kindly sent me a letter with some biographical notes. The biography written below is based on his original letter.
Robert H. Goetz was born in Frankfurt on April 17, 1910, into the family of sculptor Johan Konrad Goetz and his wife Emilie. He spent the years of the First World War with his grandparents in a small village in the Black Forest, the school of which consisted of one room and a teacher for all grades. The
Why does the giraffe not faint?
In 1940s, there was an intense interest in the cause of high blood pressure. Goetz often asked himself: “What about the blood pressure in the giraffe? And why does the giraffe not faint when moving the head suddenly through a circle of 20 feet from the head down position to the upright? If hypertensive, what is the serum cholesterol? And with a trachea 8-feet-long, how does it deal with that large dead space?” These and many more questions awaited answers when he set out to study the physiology
The first successful clinical coronary artery bypass operation
The early 1950s saw the beginning of direct vascular surgery. It was a time when advances in the treatment of coronary artery disease made headlines in the world press. It was also the time Goetz came to America. Goetz became Associate Professor of Surgery at the Albert Einstein College of Medicine in 1957 and a full Professor and attending surgeon at Bronx Municipal Hospital in 1961. He held both positions until his retirement in 1982 (Fig 5).
Goetz described his move as follows:
In 1954, I
The world unimpressed
Goetz gave the answer to the above question in his letter to me:
You wonder why I did not pursue the subject. The reasons were several. First, with the exception of the attending cardiologist Dr. Jordan, our medical colleagues were violently against the procedure. We even came in for severe criticism from some of our surgical colleagues. Enlisting the help of Dr. Jordan, we literally had to snatch the patient from the medical department. Second, although the patient did very well our medical
Oblivion
It is often mentioned in surgical literature that the first successful coronary artery bypass operation using suture technique was done by Kolesov in Russia. Although it is, certainly, a fair statement, it is regrettable that Goetz’s pioneering work is often overlooked. Kolesov also reported the first substantial experience with coronary artery bypass grafting. It is noteworthy that in his first article on the subject published in Russian in 1965, Kolesov acknowledged the pioneering
Epilogue
The coronary bypass operation has evolved from the procedure that “can only be guessed” to one of the most frequently performed operations today. Goetz had a remarkable ability to stay focused on his work. His life was full of mental torment and material adversity. Yet, he endured through it all. He did what he believed was right, honorable, and of benefit to humanity. He did what he could, the recognition will come.
It might be a pleasant surprise for German surgeons to learn that the first
Acknowledgements
I am grateful to Dr Dmitri D. Tcherkas for his most valuable suggestions and encouragement.
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