Andreas Roland Grüntzig (25 June 1939 – 27 October 1985) was a German American radiologist and cardiologist, with foundational interest, training, and research in epidemiology and angiology. He is known for being the first to develop successful balloon angioplasty for expanding lumens of narrowed arteries. He was born in Dresden.

Early life

Andreas Roland Gruentzig was born in Dresden, Germany on 25 June 1939, shortly before the start of World War II. His father, Dr. Wilmar Gruentzig (1902–1945), was a secondary-school science teacher with a PhD in chemistry. Wilmar was conscripted into the meteorological service of the Luftwaffe during World War II. He presumably died during the war. His mother was Charlotta (née Zeugner) Gruentzig (1907-1995), and a teacher. His older brother was Johannes Gruentzig. After his birth in Dresden, in 1940, the family moved to the house of a relative in the small town of Rochlitz in western Saxony. After the war, Charlotta and her sons moved to Leipzig along with her sister Alfreda Beier and her mother. In 1950, Charlotta moved her family to Buenos Aires, Argentina to live with her husband's brother and wife. Unhappy and homesick, Charlotta and her two sons moved back to Leipzig two years later. Gruentzig and his brother Johannes entered high school at the Thomasschule zu Leipzig. Gruetzig graduated from the Thomasschule in 1957 with highest honors. In 1956, his brother Johannes fled across the border to Hanover. Gruentzig followed a year later.

Gruentzig studied at Bunsen Gymnasium while his brother enrolled as a medical student at Heidelberg University. Gruentzig began his medical studies at Heidelberg University in the autumn of 1958, subsequently graduating on 8 April 1964. He then rotated through a series of internships in Mannheim, Hanover, Bad Harzburg, and Ludwigshafen. His studies included internal medicine and vascular surgery. In 1966, Gruentzig returned to Heidelberg University to take on a staff assistant job at the university's Institute for Social and Occupational Medicine, investigating risk factors for cardiovascular disease, chronic bronchitis, and liver degeneration. In 1967, he departed for a six-month paid fellowship to study epidemiology at the University of London School of Hygiene. In 1968, he returned to Heidelberg. Early in 1968, he left for a six-month assistant doctor's job in Darmstadt at the Max Ratschow Clinic.

In November 1969, Gruentzig and his future wife Michaela moved to Zürich where he worked in the department of Angiology at the University Hospital of Zürich.

Groundbreaking procedure: coronary angioplasty

In the late 1960s, Gruentzig learned of the angioplasty procedure developed by Charles Dotter, an American, at a lecture in Frankfurt, Germany. Encountering bureaucratic resistance in Germany to his exploration of angioplasty techniques, Gruentzig moved to Switzerland in 1969.

Gruentzig's first successful coronary angioplasty treatment on an awake human was performed on 16 September 1977, in Zürich, Switzerland. He expanded a short, about 3 mm, non-branching section of the Left Anterior Descending (LAD) artery (the front branch of the left coronary artery) which supplies the front wall and tip of the heart (see coronary circulation) which had a high grade stenosis, about 80%, of the lumen. Gruentzig presented the results of his first four angioplasty cases at the 1977 American Heart Association (AHA) meeting, which led to widespread acknowledgement of his pioneering work.

The immediate results of this treatment, despite using only a carefully kitchen-built catheter (crude by current standards), were quite good. The patient became and remained free of angina after this treatment. This initial patient's result was electively rechecked by angiography at Emory University on the 10-year anniversary of the initial treatment. The LAD narrowing, after this 10-year timespan, remained almost perfectly expanded. There was minimal residual narrowing, probably less than 10%, as seen in similar angles and multiple different views compared with photographs of the original, 10 years earlier.

The excellent results of this initial and subsequent patients were critical to the rapid development and growing acceptance of the angioplasty treatment option. Gruentzig recognized multiple important issues early: (a) the treatment would not be readily accepted by most physicians, especially bypass surgeons, (b) it could easily lead to bad outcomes without great care in selection of which patients/lesions to treat and of the treating physicians, and (c) it required careful teaching of the technique and its potential difficulties and pitfalls to other physicians, so as to proactively reduce the occurrence of poor results. Understanding these issues and tireless effort on his part are widely recognized in cardiology as being of fundamental importance to the ultimate success of the technique.

Emory University Hospital 1980-1985

Andreas Gruentzig joined Emory University School of Medicine in 1980 after a pivotal conversation with Dr. Spencer B. King III, who emphasized the importance of an academic appointment over a position at the Cleveland Clinic. Grüntzig wanted to continue his research and lecture, a goal the Clinic could not support since it lacked a medical school. He accepted Emory's offer and was appointed professor upon arrival.

At Emory, Grüntzig and King pioneered live coronary angioplasty training courses. They created a closed-circuit television system connecting the catheterization lab to a nearby auditorium. During these early "live demonstration" sessions, one performed the angioplasty while the other moderated to teach the thinking behind each step.

His medical billing assistant, Nona Law, led the way with CPT codings for all of Dr Gruentzig's procedures.

Death and legacy

Gruentzig, an instrument-rated pilot, and his wife, Margaret Anne, died in an airplane crash in their Beechcraft Baron in Forsyth, Georgia, on 27 October 1985. They are both buried in Riverside Cemetery (Macon, Georgia). The Grüntzig Ethica award for contributions to interventional cardiology is named for him.

See also

  • History of invasive and interventional cardiology

References

Further reading

  • Andreas Grüntzig and Angioplasty (includes video clips)