REFLECTIONS OF THE PIONEERS Beginning of percutaneous coronary interventions: Zurich 1976–1977

FIGURE 1. Andreas Gr€untzig. By introducing his concept of percutaneous coronary intervention (PCI), Andreas Gr€untzig (Figure 1) has affected the most profound change not only in cardiology but also in cardiac surgery. This innovation started its triumphal march in the last 2 decades of the 20th century, but the idea was developed and experimentally tested in Zurich in 1974 to 1975. The concept of a balloon-tipped catheter to dilate arteriosclerotic lesions was doubted by many, and early clinical application of PCI was anything but straightforward. Having had the privilege to work closely with Andreas Gr€untzig during the development of PCI in Zurich, I was invited by Dr Lawrence Cohn, Editor-in-Chief, to add some observations about this epochal discovery. Two observations emerge from Dr Gr€untzig’s early work in Zurich: (1) percutaneous balloon dilatation of the coronary stenosis was neither a divine inspiration nor a stroke of luck, but a product of long development and thorough experimental evaluation; (2) its first clinical application was by no means as simple as it appears today.