George E. Green (doctor)

Last updated
George E. Green
George E Green.jpg
Green in 1964
Born
George Edward Green

(1932-01-18) 18 January 1932 (age 92)
Brooklyn, New York, U.S.
Alma mater Yale College, Yale Medical School
Occupation(s)Cardiac surgeon, author
Board member of American Board of Thoracic Surgery
Spouse
​
​
(m. 1960)​

George E. Green is an American cardiac surgeon best known for pioneering and implementing the first surgical procedure of the left coronary artery bypass graft using the internal thoracic artery sutured to the left anterior descending coronary artery to bypass obstruction to the heart circulation in the late 1960s. [1] He applied these techniques in 1968 at New York University Medical Center. In 1970 he was hired to establish St. Luke's Hospital's (now Mount Sinai Morningside) cardiac surgery program in Manhattan, New York, [2] which by 1982 was seeing approximately 1,800 cases a year, the biggest program in the state. Green has lectured internationally on the topic, [3] and has written numerous reports on internal thoracic artery grafting, [4] [5] as well as co-authoring Surgical Revascularization of the Heart: The Internal Thoracic Arteries. [6] [7]

Contents

Early life

George E. Green was born on January 18, 1932, and raised in Brooklyn, New York, where he attended grade school and high school. He attended Yale College and graduated from Yale School of Medicine, then returned to New York to intern at Bellevue Hospital and complete a residency at Saint Vincent's Hospital and the Veterans Administration Hospital. [3] From 1962 to 1964 he served as a surgeon on United States Navy Reserve active duty at U.S. Naval Hospital in Camp Pendleton, California. He also completed a residency in thoracic and cardiovascular surgery from 1966 to 1968 at New York University Medical Center. [8]

Career

Green was the first cardiac surgeon to successfully perform a left coronary artery bypass graft using the internal thoracic artery [9] sutured to the left anterior descending coronary artery to bypass obstruction to the heart, in 1968. [10] [11] [12] [3] [7] At the time, many experts believed that the internal mammary artery was too small to splice into the coronary arteries. The bypass called for 20 stitches to attach the vessel. [13] "Many years ago George Green stood alone in support of the internal mammary artery as a superior conduit," Dr. John L. Ochsner of the Ochsner Clinic in New Orleans had written. "In the years since, many of us have joined his ranks." [14]

Green began working with microsurgery techniques while working as an assistant with Max Som at Beth Israel Medical Hospital Center. Som was looking for a better solution to the reconstruction of the esophagus post-cancer treatment. In order to improve on the technique, Green introduced himself to Julius H. Jacobson, who had newly arrived at the Mount Sinai Medical Center, and was the first American to publish about using a surgical microscope to anastomose the smallest blood vessels. Green was given access to Jacobson's lab and practiced the same procedure. [15] [3] [16]

In an excerpt from Green's "After 50 years, a personal reflection on the development of internal thoracic artery (ITA) grafting", he reported that, "Although the procedure had been prohibited at the New York University Hospital, David Tice, Director of Surgery at the affiliated New York Veterans Administration Hospital, invited me to do it there. I did the first internal thoracic artery (ITA)-left anterior descending (LAD) artery anastomosis in the United States there in February of 1968." [17] [16]

In 1968 Green was a spokesman for the research team at the New York University of Medicine at the annual Clinical Congress of American College of Surgeons, sharing the outcomes of 12 patients on whom he had performed the surgery. [18] [10] In 1971 he documented his research and work on "coronary artery bypass grafts for congestive heart failure; a report of experiences with 40 patients" in The Journal of Thoracic and Cardiovascular Surgery (supported in part by a grant from the National Heart and Lung Institutes of the National Institutes of Health), which was read at the 51st Annual Meeting of The American Association for Thoracic Surgery, in Atlanta, Georgia in April 1971. [19] In 1972, at the Coronary Artery Surgery Clifton Symposium, Williams Glenn, chief of surgery at Yale School of Medicine, spoke against operating on the heart's arteries, while Green gave arguments for it. [20] In 1973 Green spoke on the topic at the scientific sessions at the American Heart Association, Pennsylvania Affiliate. [21] Green served as president of the International Symposium Internal Thoracic Artery for Myocardial Revascularization in the early 1990s, and has lectured in France, Sweden, Norway, Germany, Greece, England, and Argentina, among others. [3]

Personal life

Green is married to children's book author Sheila Greenwald. They have two sons. [22]

Related Research Articles

<span class="mw-page-title-main">Coronary artery bypass surgery</span> Surgical procedure to restore normal blood flow to an obstructed coronary artery

Coronary artery bypass surgery, also known as coronary artery bypass graft, is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic heart.

<span class="mw-page-title-main">Cardiac surgery</span> Type of surgery performed on the heart

Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease ; to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation.

<span class="mw-page-title-main">Internal thoracic artery</span> Artery of the thorax

In human anatomy, the internal thoracic artery (ITA), also known as the internal mammary artery, is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with one running along each side of the sternum, to continue after its bifurcation as the superior epigastric and musculophrenic arteries.

Hybrid coronary revascularization (HCR) or hybrid coronary bypass is a relatively new type of heart surgery that provides an alternative to traditional coronary artery bypass surgery (CABG) or percutaneous coronary intervention by combining the two into one operation. It is this combining aspect that "hybrid" refers to. HCR is one of several types of hybrid cardiac surgery; it is not to be confused with a MIDCAB procedure, which uses the smaller thoracotomy incision but does not involve coronary stenting.

A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively normal area. It is commonly performed due to inadequate blood flow (ischemia) caused by atherosclerosis, as a part of organ transplantation, or for vascular access in hemodialysis. In general, someone's own vein (autograft) is the preferred graft material for a vascular bypass, but other types of grafts such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Dacron), or a different person's vein (allograft) are also commonly used. Arteries can also serve as vascular grafts. A surgeon sews the graft to the source and target vessels by hand using surgical suture, creating a surgical anastomosis.

Transmyocardial laser revascularization (TMR) is a procedure used to treat inoperable heart disease in people with persistent angina that is not relieved by any other revascularization method.

Minimally invasive direct coronary artery bypass (MIDCAB) is a surgical treatment for coronary heart disease that is a less invasive method of coronary artery bypass surgery (CABG). MIDCAB gains surgical access to the heart with a smaller incision than other types of CABG. MIDCAB is sometimes referred to as "keyhole" heart surgery because the operation is analogous to operating through a keyhole.

<span class="mw-page-title-main">Off-pump coronary artery bypass</span>

Off-pump coronary artery bypass or "beating heart" surgery is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass as a treatment for coronary heart disease. It was primarily developed in the early 1990s by Dr. Amano Atsushi. Historically, during bypass surgeries, the heart is stopped and a heart-lung machine takes over the work of the heart and lungs. When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as OPCAB, the heart is still beating while the graft attachments are made to bypass a blockage.

<span class="mw-page-title-main">David Sabiston</span> American surgeon

David Coston Sabiston, Jr., M.D.,, F.A.C.S. was an early innovator in cardiac surgery. In 1962, he performed a seminal procedure that paved the way for modern coronary-bypass surgery, grafting a vein from a patient's leg to bypass a blocked coronary artery during open-heart surgery. The patient died from unrelated complications, but Sabiston's technique and other surgeons' improvements on it led to the development of surgical coronary revascularization as it exists today.

Minimally invasive cardiac surgery, encompasses various aspects of cardiac surgical procedures that can be performed with minimally invasive approach either via mini-thoracotomy or mini-sternotomy. MICS CABG or the McGinn technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy.

Vessel harvesting is a surgical technique that may be used in conjunction with a coronary artery bypass graft (CABG). For patients with coronary artery disease, a physician may recommend a bypass to reroute blood around blocked arteries to restore and improve blood flow and oxygen to the heart. To create the bypass graft, a surgeon will remove or "harvest" healthy blood vessels from another part of the body, often from the patient's leg or arm. This vessel becomes a graft, with one end attaching to a blood source above and the other end below the blocked area, creating a "conduit" channel or new blood flow connection across the heart.

Robert S. Poston is an American cardiac surgeon at University of Arizona Medical Center most noted for his work in robot-assisted heart surgery and Coronary Artery Bypass Surgery.

<span class="mw-page-title-main">Hybrid cardiac surgery</span>

A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional, more invasive surgical part with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy imaging in a hybrid operating room (OR) without interruption. The hybrid technique has a reduced risk of surgical complications and has shown decreased recovery time. It can be used to treat numerous heart diseases and conditions and with the increasing complexity of each case, the hybrid surgical technique is becoming more common.

Peter Allen was a Canadian surgeon who played a leading role in improving cardiac surgery techniques. Along with Dr. Philip Ashmore, Dr. W.G. (Bill) Trapp and Dr. Ross Robertson, he performed the first Open Heart Surgery in British Columbia on 29 October 1957 at Vancouver General Hospital, by closing an Atrial Septal Defect (ASD) in 9 year old John Evans, using Cardiopulmonary Bypass (CPB).

<span class="mw-page-title-main">Ischemic cardiomyopathy</span> Medical condition

Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction. This cardiomyopathy is one of the leading causes of sudden cardiac death. The adjective ischemic means characteristic of, or accompanied by, ischemia — local anemia due to mechanical obstruction of the blood supply.

Vasilii Ivanovich Kolesov was one of the pioneers of global cardiac surgery. He was the first to perform successful internal coronary artery bypass surgery using mammary artery–coronary artery anastomosis in 1964. Also in 1964, he performed the first successful coronary bypass using a standard suture technique. Kolesov was a recipient of the USSR State Prize and Honoured Worker of Science of the RSFSR (1964).

Uwe Klima is UAE based professor of surgery and a faculty member at the Hannover Medical School, Germany. He also is the medical and managing director at German Heart Centre, Dubai.

<span class="mw-page-title-main">Anil Bhan</span> Indian cardiologist

Dr. Anil Bhan is the Chairman of Cardiac Surgery Heart Institute, Medanta Hospital, Gurugram, India. He graduated from Medical College Srinagar. He has the largest experience in aortic surgery in India since he has designed and developed more than 50 surgical instruments in the field of cardiac surgery. He was one of the team members to perform the first successful heart transplant in India in1994. He served as a co-founder of Max Heart and Vascular Institute, Saket, New Delhi, Director and Chief Co-Ordinator, Cardio thoracic and Vascular Surgery, MHVI, Saket.Additional Professor, Cardiothoracic Surgery and Vascular Surgery, AIIMS, New Delhi.

John D. Puskas is an American researcher, author, inventor and cardiovascular surgeon. As of 2022, he is Professor, Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, and chairman, Department of Cardiovascular Surgery at Mount Sinai Morningside, Mount Sinai Beth Israel and Mount Sinai West. He holds 11 U.S. patents and co-founded the International Coronary Congress and the International Society for Coronary Artery Surgery. He is credited by ResearchGate with 330 publications and 15,234 citations and as of 2022 Scopus reports an h-index of 62. Puskas is known for advancing coronary artery bypass (CABG) surgery by refining surgical techniques for all-arterial, off-pump CABG and inventing finer instruments to be used for advanced coronary bypass surgical procedures. He is credited with performing the first totally thoracoscopic bilateral pulmonary vein isolation procedure. He is the co-editor of State of the Art Surgical Coronary Revascularization, the first textbook solely devoted to coronary artery surgery.

Mario F.L. Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA is an Italian cardiothoracic surgeon who is the Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery (II) and Professor of Clinical Epidemiology and Health Services Research at Weill Cornell Medicine and an attending cardiac surgeon at NewYork-Presbyterian Hospital and Weill Cornell Medical Center. He is an expert in coronary revascularization and clinical trialist. He is known for conducting the PALACS trial, which demonstrated that posterior pericardiotomy at the time of cardiac surgery reduced the incidence of post-operative atrial fibrillation and pericardial effusion.

References

  1. ↑ Nancy Cacioppo, "Story of a Heart", The Journal News , page 17, February 15, 1971
  2. ↑ "Mount Sinai Historical Timeline - 1846 - 2021 (Dr. George E. Green 1970)" (PDF). Mount Sinai Morningside. Retrieved February 9, 2022.
  3. 1 2 3 4 5 "Interview with George E. Green, MD by Norma M.T. Braun, MD". Icahn. June 17, 2017. Retrieved February 8, 2022.
  4. ↑ "lnternal Mammary Artery-to-Coronary Artery Anastomosis: Three-Year Experience with 165 Patients by Dr. George E. Green". Annals Thoracic Surgery. September 3, 1972. Retrieved February 4, 2022.
  5. ↑ "Medical Articles Published by GE Green". PubMed.gov. Retrieved February 3, 2022.
  6. ↑ "Surgical Revascularization of the Heart: The Internal Thoracic Arteries by Green, Singh, and Gibbons". Kenyatta University . Retrieved February 3, 2022.
  7. 1 2 Peggy Eastman, "Why Women Should Try to Avoid Bypasses", The Paducah Sun , page 38, June 25, 1986
  8. ↑ Alice Murray, "Surgeon Takes Shortcut to Relieve Heart Surgery", Daily News New York , page 506, May 30, 1982
  9. ↑ David Zinman, "Dye Maps Paved Way for Bypass", The Paducah Sun, page 31, July 5, 1992
  10. 1 2 "Some Other Kinds of Heart Surgery", The Press Democrat Santa Rosa, page 4, April 20, 1969
  11. ↑ Dolores Frederick, "His Heart Detour Great", The Pittsburgh Press , page 1, March 4, 1973
  12. ↑ "Bypass Less Successful for Small People", Press and Sun-Bulletin , page 29, December 23, 1985
  13. ↑ William Rice, "They Command an Arsenal That Fights For Life", Daily News in New York, page 11, January 21, 1971
  14. ↑ "The Doctor's World; Technique Changes in Bypass Surgery by Lawrence K. Altman, M.d." New York Times . August 9, 1988. Retrieved February 2, 2022.
  15. ↑ "Oral history interview conducted by Dr. William Stoney with Dr. George Green on May 5, 1998". Vanderbilt Library. May 5, 1998. Retrieved February 3, 2022.
  16. 1 2 "Demand Increases for Artery Bypass Surgery", The Boston Globe, page 115, December 10, 1972
  17. ↑ Green, G. E.; Puskas, J. D. (September 7, 2018). "After 50 years, a personal reflection on the development of internal thoracic artery (ITA) grafting". Annals of Cardiothoracic Surgery. 7 (5). Europe PMC: 644–651. doi: 10.21037/acs.2018.05.14 . PMC   6219954 . PMID   30505749.
  18. ↑ Delos Smith, "Microscopic Surgery Saves Heart Patients", Indianapolis News , page 3, October 16, 1968
  19. ↑ Spencer, Frank C. (October 1971). "Coronary artery bypass grafts for congestive heart failure: A report of experiences with 40 patients pages 529-542". The Journal of Thoracic and Cardiovascular Surgery. 62 (4): 529–542. doi: 10.1016/S0022-5223(19)42022-9 .
  20. ↑ "Coronary Artery Surgery Clifton Symposium Topic", The Herald-News in New Jersey, page 14, May 6, 1972
  21. ↑ "American Heart Association Underway Now", The Daily News in Lebanon, Pennsylvania, page 30, May 3, 1973
  22. ↑ "Surgeon Takes Shortcut to Relieve Heart Surgery", Daily News, page B-50, May 30, 1982
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