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Throughout the history of medical treatments, one can only presume that not many catheter slips ended particularly well for the patients in question. But this is not one of those cases. On the contrary, this happens to be one of the blessed times in which accident turns into innovation.

 

Dr. F Mason Jones, Jr., who was working at the Cleveland Clinic, performed his first selective coronary arteriogram on the 30th of October 1958. The procedure was to be done by administering an injection with a contrastive agent (dye) into the aortic valve of a 26 year-old patient experiencing rheumatic heart disease so that the abnormalities within parts of the heart would show up on X-rays. The procedure had to be done by injecting the dye in the aortic valve, which is located between the left ventricle and the aorta (the largest artery in the body), since it maintains a one-way blood flow through the heart.

 

“Well aware of the fact that the heart would respond to this misstep via fibrillation, the doctor simply yelled at his patient “Cough! Cough!! Cough, you b#&&*!!!.”, a common practice of restoring patients’ normal heart beat, this being recalled in his own daughter’s words who fainted at the sight, in what must now be such a sweet childhood memory.”

 

The bad news was that instead of doing so, Dr. Mason slipped the catheter and the contrastive agent went through the right coronary artery that provides blood to the right side of the heart (right atrium, right ventricle and bottom portions of both ventricles), which in turn pumps blood to the lungs. High doses of dye entering the patient’s system through the right coronary artery usually resulted in the patient’s death. Not this time though. Well aware of the fact that the heart would respond to this misstep via fibrillation, the doctor simply yelled at his patient “Cough! Cough!! Cough, you b#&&*!!!.”, a common practice of restoring patients’ normal heart beat, this being recalled in his own daughter’s words who fainted at the sight, in what must now be such a sweet childhood memory.

 

The good news, besides the patient not dying, was that Dr. Mason had realized that injected in smaller dosage, the dye could be administered to that crucial part of the heart as well, thus revolutionizing heart surgery, by producing a large collection of angiograms that would later be thoroughly studied by René Favaloro, father of the coronary bypass surgery. Who knew that dropping catheters would one day come in handy?  

 

Written by O.P. Sources: American Heart Association (circ.ahajournals.org) The Society for Cardiovascular Angiography and Interventions (scai.org) my.clevelandclinic.org, heart.org.