Meet the EuroPCR 2024 Andreas Grüntzig Ethica Awardees

Each year, the Andreas Grüntzig Ethica Award – the highest honour in the interventional cardiology community – is presented to individuals who have contributed in an extraordinary way to the PCR mission.

What inspired you to specialise in cardiac surgery?

When I graduated from medical school in 1971, cardiac surgery was in its pioneering phase. Nothing appeared impossible – the doors were opened to congenital heart surgery, valve repair and replacement, coronary artery bypass grafting and heart transplantation, etc. Of course, at this time, there was no interventional cardiology and surgery was the only way to treat heart disease. Who wouldn’t have been attracted to this field? The work of Alain Carpentier then motivated me to focus on valve surgery.

What are your main career achievements?

I would have to say that developing the edge-to-edge technique for mitral valve repair – which was inspired by observations of the congenital double-orifice mitral valve anomaly – is the greatest achievement of my career, given its subsequent basis for percutaneous treatment. Another major contribution is the invention of the clover technique, which has turned out to be extremely useful for many patients with tricuspid regurgitation. Finally, I am proud that for the past two decades or so I have been promoting cross-training in catheter technologies among my surgical colleagues. I recognised early that huge steps forward could be made with transcatheter technologies and that we, as cardiac surgeons, could become experts at both. 

What are you working on at the moment?

I'm still a senior consultant at the San Raffaele University Hospital and this gives me the opportunity to share my experience as part of the heart team and continue in patient care. I am also busy with the Alfieri Heart Foundation I founded, which keeps me at the forefront of cardiac research, as we endeavour to invent and test new treatments and devices for heart valve diseases. We also aim to promote the training of highly trained professionals, with a progress-oriented mindset, who will be able to apply the most advanced techniques and technologies for the benefit of patients.

What inspired you to specialise in interventional cardiology?

I think that many interventional cardiologists are like myself, slightly frustrated engineers who really enjoy fixing problems. I have always been interested in physiology and I like to think of myself as a ‘human hydrologist’, solving flow issues in a human model. I consider it a real privilege and pleasure to be able to do this and I never think of it as work.

What are your main career achievements?

I was part of the team involved in the development of intravascular ultrasound, but my main achievement would have to be the MitraClip. Training at Stanford University, I was encouraged to push the envelope of healthcare and to think about problem-solving at a higher level. I heard of Professor Alfieri’s edge-to-edge technique when I was investigating percutaneous ideas for mitral valve repair using much more complex techniques, revolving around annuloplasty, and it was like a light-bulb moment, I thought that something so elegant and simple could be achievable with a catheter. That realisation was the start of Evalve, Inc., the company that went on to develop the MitraClip. It was a huge team effort, involving passionate physicians and clever engineers, and success was hard won – we faced initial hostility from some in the surgical sector and potential failure on several occasions. And although MitraClip was first implanted less than a year after the first TAVI procedure, the success of this approach has taken much longer to be realised, perhaps due to complexities of the AV valves.  

What are you working on at the moment?

As well as really enjoying continuing to practice clinical medicine and taking care of patients, I am also inspired to use innovation to try to make healthcare more scalable and more equitable globally. I teach at Stanford Biodesign, am Vice Chairman of the Board of a non-profit incubator, Fogarty Innovation, and support several different healthcare projects in Africa. Part of my work currently is in the perinatal, maternal and infant health space, which has a huge unmet need. We have developed the US standard-of-care device for managing postpartum haemorrhage, the JADA system, and are now focusing on preterm labour. I want to leverage the successes and failures I've had in different projects to try to smooth the path for the next generation of innovators.