René Favaloro

Dr. René Gerónimo Favaloro (July 14, 1923 – July 29, 2000) was an Argentine cardiac surgeon who created the technique for coronary bypass surgery.

In 1967, René Favaloro became the first surgeon to perform bypass surgery on a patient suffering from coronary artery disease. This procedure later developed into an important technology in coronary surgery.

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Early life

Favaloro was born and raised in 'El Mondongo', a middle class neighborhood of La Plata, Argentina. At an early age he developed a love for football soccer, favoring Gimnasia y Esgrima La Plata, a popular club in the city.

In 1936, Favaloro was admitted into the Colegio Nacional de La Plata. After graduating from high school, he was admitted as a student to the Medical Sciences Faculty of the Universidad Nacional de La Plata. During his third year, he started attending the Hospital Policlínico, a medical center that received the complicated cases from practically all of Buenos Aires province and brought him into contact with patients for the first time.

He attended procedures carried out by professors José María Mainetti and Federico E.B. Christmann, from whom he learned the simplicity and standardization that he would later apply to cardiovascular surgery: perhaps his greatest contribution to cardiovascular operating techniques.

He served his medical residency at the Hospital Policlínico.

In 1949 he applied for a post as a medical auxiliary, but the offer of the post required him to sign that he accepted the doctrine of the current Argentine government a to be a member of the Perón's political party, something he didn't accepted. He was then offered a locum post as the only doctor in the small town of Jacinto Aráuz in the La Pampa Province. When the permanent doctor died, he took the post permanently, and then brought in his brother Juan José.

Working with others in the community, they took steps to improve the general level of health in the region.

Thoracic surgery

He read about developments in cardiovascular interventions, and developed an enthusiasm for thoracic surgery. At one visit to La Plata, he met Professor Mainetti, who pointed him in the direction of the Cleveland Clinic.

Although in the beginning he had doubts about leaving his profession as a rural physician, he thought that he could make a greater contribution to the community when returning from the United States. With few resources and some rudimentary English, he decided to travel to Cleveland. He first worked as a resident and later on as a member of the surgery team, working with Donald B. Effler, head of cardiovascular surgery, F. Mason Sones, Jr., who was in charge of the Angiography Laboratory and William L. Proudfit, head of the Department of Cardiology.

In the beginning, the major part of his work related to valvular and congenital diseases; later on he became interested in other areas. Every day, having hardly finished working in the surgery room, Favaloro would spend hours upon hours reviewing coronary angiograms and studying coronary arteries and their relation with the cardiac muscle. The Laboratory of Sones, father of the coronary arteriography, had the most important collection of angiograms in the United States.

At the beginning of 1967, Favaloro began to consider the possibility of using the saphenous vein in coronary surgery. He put his ideas in practice for the first time in May of that year. The standardization of this technique, called bypass or myocardial revascularization surgery, was the fundamental work of his career, which ensured that his prestige would transcend the limits of that country, as the procedure radically changed the history of coronary disease. In 1970 he published a book called Surgical Treatment on Coronary Arteriosclerosis, and published it in Spanish with the name Tratamiento Quirúrgico de la Arteriosclerosis Coronaria.

The creation of the Favaloro Foundation

In 1971 Favaloro, returned to Argentina with the dream of developing a center of excellence similar to the Cleveland Clinic, that combined medical attention, investigation and education.

Bearing that in mind he founded the Fundación Favaloro in 1975 along with other collaborators. He took great pride in having trained more than 450 residents from all over Argentina and the Americas. Favaloro contributed to raise the standard level of his specialty in benefit of the patients through innumerable courses, seminars and conferences organized by the Fundación, among them the distinguished 'Cardiology for the Consultant' (Cardiología para el Consultante) held every two years.

In 1980 Favaloro established the 'Basic Investigation Laboratory' (Laboratorio de Investigación Básica), which was financed with his own money for a long timespan and which, at the time, depended upon the support of the Investigation and Teaching Department of the Fundación Favaloro). Subsequently it became the Institute of Investigation in Basic Sciences of the University Institute of Biomedical Sciences (Instituto de Investigación en Ciencias Básicas del Instituto Universitario de Ciencias Biomédicas) which in turn, was transformed into the Universidad Favaloro in August 1998.

In 1992 the nonprofit Favaloro Foundation Institute of Cardiology and Cardiovascular Surgery (Instituto de Cardiología y Cirugía Cardiovascular de la Fundación Favaloro) opened in Buenos Aires. With the motto "advanced technology at the service of medical humanism", this institute offers highly specialized services of cardiology, cardiovascular surgery and heart, lung, cardiopulmonary, liver, kidney and bone marrow transplants, among other areas. Favaloro focused his career there, surrounded by a selected group of professionals.

He kept his emphasis in disease prevention and teaching his patients basic rules of hygiene which could promote a drop in the number diseases and the mortality rate. Bearing that objective in mind the Fundación Favaloro researches for illness detection, different prevention programmes (like the course to quit smoking) and many publications for the people were made through the Centro Editor de la Fundación Favaloro (Publishing Center of the Favaloro Foundation), which ceased to operate in 2000.

By the year 2000, Argentina was already submerged in an economic and political crisis, and the Favaloro Foundation US$ 75 million in debt. Favaloro requested the government to pay its debts to the Foundation on repeated occasions without receiving an official response. On July 29 of that year, Favaloro took the tragic decision of committing suicide; in bitter irony, shooting himself in the heart. After his death, it was revealed that he had sent a letter to Argentine President Fernando de la Rúa, that had never been read, in which he expressed being tired of "being a beggar in his own country."

The Favaloro Foundation is currently one of the largest institutions dedicated to cardiology in the Americas.

Recognitions and distinctions

Favaloro was an active member of 26 societies, corresponding of 4, and honorary of 43. He received innumerable international distinctions. The ones that stand out are: John Scott Prize 1979, granted by Philadelphia; the creation of the Chair of Cardiovascular Surgery "Dr René G. Favaloro" (Tel Aviv University, Israel, 1980); the distinction of the Fundación Conchita Rábago de Giménez Díaz (Madrid, Spain, 1982); the Teacher Prize of Argentinian Medicine (1986); the Distinguished Alumnus Award of the Cleveland Clinic Foundation (1987); The Gairdner Foundation International Award, granted by the Gairdner Foundation (Toronto, Canada, 1987); the René Leriche Prize 1989, granted by the International Surgery Society; the Gifted Teacher Award, granted by the American College of Cardiology (1992); the Golden Plate Award of the American Academy of Achievement (1993); the Prince Mahidol Prize, granted by His Majesty the King of Thailand (Bangkok, Thailand, 1999).

Favaloro on television

Favaloro also participated in educational programming for the public, distinguishing himself in the television series The great medical themes, and in numerous conferences in Argentina and throughout the world on topics such as medicine, education, and modern society.

Works by Favaloro

René Favaloro published more than three hundred works in his specialty. Owing to his passion for history, he also wrote two books about General José de San Martín.

• Surgical Treatment of Coronary Arteriosclerosis (1970)
• Recuerdos de un médico rural ("Memories of a rural doctor", 1980)
• ¿Conoce usted a San Martín? ("Do you know San Martín?", 1986)
• La Memoria de Guayaquil ("The memory of Guayaquil" 1991)
• De La Pampa a los Estados Unidos ("From the pampa to the United States", 1993)
• Don Pedro y la Educación ("Don Pedro and education", 1994)

References

• This article draws heavily on the corresponding article in the Spanish-language Wikipedia, which was accessed in the version of 12 March 2005. It was translated by the Spanish Translation of the Week collaboration.