When doctors first look at sutureless anastomosis devices created by new
technologies, the most frequent comment is how amazingly easy it is to
create a vascular anastomosis and, as a direct consequence, they believe
anybody could play the role of the cardiovascular surgeon. Pessimistic
c- diovascular surgeons, on their side, think that creating a machine
capable of perfectly reproducing their core activity, which consists in
making an- tomosis, will kill their profession. Actually, no medical
specialty's demise has been more often predicted and, at the same time,
more greatly ex- gerated than that of cardiovascular surgery. According
to its detractors, - ginning in the late 1980s with the angioplasty
boom, continuing in the mid-1990s with the introduction of bare metal
stents, and then more - cently with the introduction of drug-eluting
stents, cardiovascular surgery has been on life support for nearly 15
years. This specialty's claimed collapse has generally been attributed
to recent advantages in percutaneous procedures and devices that give
the oppor- nity to non-surgeon doctors to accomplish the surgeon's work.
The reality is different. Data suggest that cardiac surgery continues to
survive and has not suffered the precipitous decline that was predicted.
From the economical standpoint, CABG is much more of a mature market and
the size of the opportunity remains impressive and relatively stable,
with around 1,500,000 procedures performed annually worldwide, at a
total cost approaching 2. 5 billion US$.
