Transforming Cardiac Catheters into Treatment Tools

Percutaneous transluminal coronary angioplasty (PTCA) transformed the cardiac catheter from a diagnostic tool into a treatment tool. The technology involved a special catheter fitted with a balloon near its tip that could be blown up to expand a narrowed coronary artery segment. For patients with angina, the procedure was an attractive alternative to coronary bypass surgery. Mayo cardiologists were among the first to adopt angioplasty and to call for controlled clinical trials to compare it to bypass surgery. Initially, cardiologists (who already performed coronary angiography) learned to perform PTCA informally. After attending one or more live demonstration courses, many began to perform angioplasty in their local hospitals. The philosophy in many contexts was “see one, do one.” By the mid-1980s, however, more rigorous training expectations were elaborated. Heart specialists who performed PTCA were described as “interventional cardiologists,” a phrase that acknowledged that this catheter-based treatment had immediate effects.