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​​​​​​​​​​​​​​​​​​​​​​Innovation in cardiac and vascular diagnosis, treatment and research has yielded a long and continued history of novel discoveries leading to many World Firsts at the Peter Munk Cardiac Centre.​​

A pioneering spirit has fuelled many important breakthroughs in cardiovascular treatment and care dating back more than 80 years.

 


  1. 1935
    First clinical use of heparin. Heparin stops blood from clotting and is used worldwide during the vast majority of open hearts surgeries. The first use of heparin to treat a patient was by a team led by Dr. Gordon Murray and Dr. Charles Best at Toronto Western Hospital.​​
  2. 1950
    Image of First pacemakerFirst pacemaker. Dr. William (Bill) Bigelow was the first to thread a wire though a patient’s vein to the patient’s heart and deliver an electrical impulse that caused the heart to beat when its own electrical system had failed. Millions of patients now depend on pacemakers to keep their hearts beating.
  3. 1953
    First use of hypothermia for heart surgery. During the Second World War, Dr. Bigelow noted that soldiers with devastating injuries who became very cold on the battlefield could survive their injuries. By lowering body temperature, he was able to safely stop the circulation, a discovery that made open heart surgery possible.
  4. 1962
    First unit dedicated to the management of patients after a heart attack, opened with the support of Mr. Percy Gardiner, TGH Trustee. This unit was established at Toronto General Hospital by Drs. Kenneth Brown and Robert MacMillan, focused nurses, physicians and surgeons on the care of patients with disease of the heart (coronary) arteries and was the precursor of all coronary intensive care units in the world today.
  5. 1976
    First use of real-time ultrasound to assess the severity of narrowed blood vessels. Non-invasive ultrasound allows physicians to determine how narrowed blood vessels are. PMCC designed and built the first device that could record blood flow in patients’ arteries in real time. These real-time frequency analyzers are now an integral component of every ultrasound machine used to assess blood flow in arteries and veins.
  6. 1977
    First description of DNA associated proteins in any human disease. Drs. Michael Sole and C.C. Liew described the role of non-histone chromatin proteins, which are important for gene structure and function, in patients with excess heart muscle (hypertrophic cardiomyopathy).
  7. 1981
    First surgical mapping and cure of a potentially lethal arrhythmia. This marked the first time that it was possible to directly visualize the electrical activity of the human heart in real time in the operating room. With this approach, we were able to identify the location of the abnormal electrical activity (arrhythmia) and surgically remove this portion of the heart, curing the patient.
  8. 1982
    First surgery to map potentially lethal arrhythmias that did not require an incision in the heart. This built on previous work where it was necessary to cut open the heart muscle to cure the arrhythmia, and led to the development of non-invasive techniques to treat patients with life-threatening abnormal hearts rhythms, like ventricular tachycardia.
  9. 1985
    Image of Gore-tex for mitral valve repairFirst mitral valve chordal replacement with expanded polytetrafluoroethylene. This technique, developed by Dr. Tirone David, cardiac surgeon, allowed the expansion of mitral valve repair and has proven to be highly effective.
  10. 1985
    First patch reconstruction of a destroyed mitral annulus. This technique resulted in a dramatic change in the outcome of patients with infection, calcification or destruction of the mitral annulus, the base of the mitral valve, and was also developed by Dr. Tirone David.
  11. 1986
    Image of Dr. David Tirone.jpgFirst stentless aortic valve for aortic valve replacement. Dr. Tirone David developed this technique of aortic valve replacement to improve the hemodynamic performance of porcine aortic valves.
  12. 1987
    First repair of a rupture of the septum of the heart. The septum separates the right and left ventricles of the heart and can rupture after a heart attack. This operation dramatically improved survival in patients who suffered a rupture of the septum of their heart after a heart attack.​
  13. 1987
    First prospective study of iliac and femoral artery balloon angioplasty. Narrowing or blockage of the arteries to the legs may cause disabling pain and may lead to amputation. PMCC was the first to establish that balloon dilation (angioplasty) was a minimally-invasive approach that could effectively treat impaired circulation. Worldwide, angioplasty is now used much more than open bypass surgery to improve the circulation to the legs.
  14. 1988
    First national study of the results of the surgery for abdominal aortic aneurysms. An aortic aneurysm is a localized weakness and enlargement of the main artery in the chest or abdomen. Death is likely when this ruptures. This cross-Canada study was the first to establish the safety and benefits of operative repair of abdominal aortic aneurysms and defined the factors that influence the decision to operate (or not) on patients with this condition. ​
  15. 1988
    Aortic ValveThe first aortic valve sparing operation to treat an aortic root aneurysm (David Operation). Young patients with aneurysms of the aortic root, the main blood vessel that comes out of the heart, are frequently associated with specific genetic syndromes. Previously, these patients were treated with a synthetic graft that had a mechanical aortic valve, which required lifelong anti-coagulation, or a tissue valve with limited durability. This operation preserved the patient’s own aortic valve, improved the quality of life and is now the established worldwide standard for treating this condition.​
  16. 1990
    First practical genetic test for viral infection of the heart. Drs. Michael Sole and C.C. Liew were the first to use of gene amplification to identify Coxsackie virus infection of the heart.
  17. 1990
    Determination of the sequence of the human myosin heavy chain, a major structural protein in the heart. This discovery, by Drs. Michael Sole and C.C. Liew, allowed investigators elsewhere to identify abnormal myosin heavy chain gene sequences which cause hypertrophic cardiomyopathy, an potentially lethal inherited form of heart disease. ​
  18. 1991
    Image of Toronto Heart ValveFirst aortic valve replacement using the Toronto SPV bioprosthesis. St. Jude Medical (in St. Paul, Minnesota) acquired the rights to manufacture the Toronto SPV valve, and Toronto General Hospital was the main site to train surgeons from around the globe to learn this new technique of valve replacement. This valve proved to be better hemodynamically, but not as durable as stented valves and was discontinued in 2005. ​
  19. 2003
    First complex coronary balloon angioplasty via the radial approach for branched vessel heart disease. With this technique, two stents are sequentially inserted into the branch point of a diseased coronary artery via the radial artery at the wrist. This approach built on the two-stent bifurcation technique developed by Dr. Antonio Colombo of Milan and proved safer than placing stents via the femoral artery in the groin. This method served as the basis for the development of other bifurcation techniques later developed by PMCC’s group and others around the world.
  20. 2003-2005
    Image of Sleep apnea and heart failureFirst randomized clinical trials to show that treating sleep apnea improves heart failure. PMCC was the first centre to show that treating sleep apnea in patients with heart failure dramatically improves the pumping function of the heart and survival. This is now the standard of practice for patients with heart failure and sleep apnea around the world.​
  21. 2007
    First demonstration that sleep deficiency can cause heart disease. This explains why chronic lack of sleep or shift work is not just associated with an increased risk of cardiovascular disease, but can actually cause heart disease by preventing the daily repair and renewal of tissues that happens in the heart. ​
  22. 2008
    First analysis of the fatal heart rhythm ventricular fibrillation in explanted human hearts. Ventricular fibrillation is a leading cause of sudden death worldwide, and could not previously be studied in humans. With this program, Dr. Nanthakumar’s group was able to study the hearts of patients who had died from ventricular fibrillation. This allowed us to discover why some patients develop this lethal heart rhythm.​
  23. 2011
    First CorMatrix Regenerative Tricuspid Valve implant. The tricuspid valve allows blood flow from the main veins in the chest into the right atrium of the heart. CorMatrix is a regenerative medicine product that provides a scaffold for the body to recreate a natural tricuspid valve. More than 100 CorMatrix implants have now been performed worldwide to repair the tricuspid valve since PMCC first used this technique.
  24. 2012
    First completely intraoperative stem cell transplantation for cardiac repair. Previous efforts at stem cell transplantation for heart repair after a heart attack required processing of the cells over days to weeks. PMCC was the first to harvest, process and transplant a patient’s own stem cells during heart bypass surgery directly into the damaged area of the heart, with cell processing taking place completely within the operating room environment (in a dedicated regenerative medicine facility).
  25. 2012
    First to prove the benefit of heart bypass surgery in patients with diabetes. PMCC led a study that showed that in patients with diabetes and advanced coronary artery disease, heart bypass surgery had lower rates of death and heart attacks than balloon angioplasty. This study had an impact on how patients with diabetes and heart disease are now managed worldwide.​

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