Professor Maisano, I hope, will also share with us his amazing professional life story, his personal quest to ease the complications of a heart attack in his own father, who was a skilled general surgeon. That’s what led Dr. Maisano on an amazing path of innovation in cardiac surgery that all patients in the world now have a chance to benefit from.
Well, it’s a career that started many years ago. And it is a very simple career. I started my practice. I started my education in cardiovascular surgery as part of a personal story, which I think is common to many, many people. My father had a very serious anterior myocardial infarction. He had an anterior myocardial infarction. At that time, there was no primary percutaneous coronary intervention available. So you know, we are talking about the 1980s. And after that, he immediately had a lot of arrhythmias. He had a really difficult situation. And the professors told me, you should go to Holland, where you will find Professor Ottavio Alfieri. He is the only one who can save your father. At that time, I was in the second year of medical school. And I went with a plane offered by the army here in Italy. We went to the Netherlands, it was like a last-hope trip. And when I saw Professor Ottavio Alfieri, I was disappointed. I was expecting this big professor, you know, old, big thick beard, like, say, in a God. But I find somebody in his mid-30s, very smart. And immediately, I felt like there was some link with this person. He actually saved the life of my father. Because he did not operate on him, he decided not to operate. This is one of the main features of Professor Alfieri, who is very well known for all the inventions and ideas and surgical operations. But one of the best features of Professor Alfieri’s skills is to know exactly what to do and what not to do to save the life of the patient. And he saved the life of my father with that. So after that, I started traveling to initially to Brescia. There was a small hospital Where Professor Ottavio Alfieri established himself after the Netherlands. Then I started the process to become a cardiac surgeon. We are in the 1990s. The 1990s was the time when cardiac surgery was flourishing. It was probably a very powerful position to be a cardiac surgeon. Interventional cardiology was starting, but it was still the time when it was a service to cardiac surgery. And so, my generation has been exposed to the most dramatic change in the history of cardiovascular medicine. Because we started as a king of the forest. And after a few years, we have realized that the forest had another king, which was at least as strong as us. This was interventional cardiology. I mean, interventional cardiology was established in the late 70s, early 80s. But it became really a strong alternative to cardiac surgery at the end of the 90s. And going forward, I mean, when the drug-eluting coronary stents became available, angioplasty became a real alternative to coronary artery bypass surgery. And after that, at the beginning of the 2000s, we started seeing the emerging technologies for percutaneous structural interventions. But in these changing times, I had a great opportunity, first of all, to work with Professor Ottavio Alfieri, who developed the Alfieri technique. And for this reason, I was involved in the very early stage of the research and development for new technologies. Treating patients with mitral regurgitation with catheter-based technologies was based on the Alfieri technique. At the same time, I was trained not only by a theory but also by Antonio Colombo. He is one of the masters of interventional cardiology. In this institution, in San Raffaele Hospital in Milan, at that time, there were three kings. There was Professro Ottavio Alfieri, Professor Antonio Columbo and Professor Carlo Pappone. He is another very famous interventionalist and electrophysiologist. So in this environment, I was very lucky to be surrounded by these mentors who helped me develop the concept [of minimally invasive heart procedures].
Although surgery remains even today an excellent solution for many patients, there are solutions that may emulate surgery with a less invasive approach. And potentially, everything we do in surgery can be done through a minimally invasive approach, through an endovascular approach. You know, as we move forward, I see endovascular procedures as the natural evolution of surgery. It is true not only in cardiac surgery but in many areas of surgery. This is happening today. It’s all about technology. It’s all about imaging. It’s all about changing the environment where we work. And obviously, this has tremendous advantages for the patients.