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Ulrich Sigwart

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Ulrich Sigwart
Born9 March 1941
Wuppertal, Germany
Education
Years active1971-2006
Known for
Medical career
ProfessionPhysician
Institutions
Sub-specialtiesCardiology
ResearchInterventional cardiology

Ulrich Sigwart (German: [ˈʊlʁɪç ˈziːkvaʁt]; born 9 March 1941) is a German retired cardiologist known for his pioneering role in the conception and clinical use of stents to keep blood vessels open, and introducing a non-surgical intervention, alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy.

Sigwart received his medical degree in 1967 from the University of Münster before gaining his MD that same year from the University of Freiburg.

In 1984, he performed the first coronary stent and 10 years later introduced percutaneous alcohol septal ablation, a non-surgical method for the treatment of hypertrophic obstructive cardiomyopathy, as an alternative to open heart surgery.

Early life and education

Ulrich Sigwart was born on 9 March 1941 in Wuppertal, Germany, the fifth child of August R. Sigwart, a Bayer Industries scientist, and his wife Elizabeth.[1][2] He was an infant when his father died under suspicious circumstances in Nazi-occupied Europe.[2] His family has its origins in Tübingen where several members played an important role at the local university.[2] Most of his ancestors were doctors, philosophers, or theologians, and a street in Tübingen is named after one of them.[2] He was raised by his mother and older siblings, at first in the Black Forest and later towards the north of Germany.[2]

Sigwart received his medical degree in 1967 from the University of Münster before gaining his MD that same year from the University of Freiburg.[3] His internship was completed in a hospital in Lörrach, Switzerland, in 1968.[3][4]

Early career

Sigwart moved to the US and completed a residency at Framingham Union Hospital, Framingham, Massachusetts, between 1968 and 1971.[3] Between 1971 and 1972 he completed a Fellowship in cardiology at Baylor College of Medicine, Houston, and then completed cardiology training at the University Hospital of Zürich in 1973.[3][5] It was during these years that Andreas Gruentzig was working with catheters designed by Charles Dotter to open blood vessels in the groin.[1]

He was appointed junior consultant at the Gollwitzer-Meier Institute in Bad Oeynhausen in Germany in 1972,[1] and the following year was recruited to set up an invasive cardiology program, where he studied angiography.[1] In 1978 he published his venia legendi thesis Die automatische Erfassung von Herzkatheterdaten (The Automatic Documentation of Cardiac Catheterisation Data) from Düsseldorf University.[1]

From 1979 to 1989 he headed the section of invasive cardiology at the Lausanne University Hospital in Switzerland.[1] There, in 1984, he performed the first coronary stent.[6]

Gruentzig had already recognized the problem of abrupt closure and restenosis after angioplasty. The need for a suitable form of intraluminal support in the hope of reducing or preventing this problem became obvious. Several investigators envisioned such devices during the first years of clinical application of angioplasty. Following reassuring animal work with self expanding mesh stents in Lausanne Sigwart reported the first human implants of such vascular scaffolds. These vascular stents, implanted in peripheral and coronary circulation, were multi-filament self-expanding, spring-like devices made of surgical steel. Sigwart's work made angioplasty predictable which significantly improved the outcome and offered a chance to overcome the problem of abrupt closure and recurrence.[citation needed][clarification needed]

In 1987, after several years of preliminary work in animals, he published a landmark paper on the use intravascular stents in humans to prevent occlusion and re-stenosis after angioplasty of coronary and peripheral arteries.[7][8] This wall stent was later replaced by balloon expandable-stents that had less risks of restenosis and thrombosis.[9]

Sigwart's early stenting work received great interest and many travelled to Lausanne to observe the technique in practice. In a 1987 paper entitled ‘Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty’, Sigwart et al. gave an interesting account of the clinical use of stents to prevent occlusion and restenosis. Sigwart's work also provided him with an opportunity to observe the outcomes and indeed the shortcomings resulting from stent therapy.[citation needed][clarification needed]

Later career

In 1989, he became director of the department of invasive cardiology at the Royal Brompton Hospital.[1]

In 1994 he introduced percutaneous alcohol septal ablation, a non-surgical method for the treatment of hypertrophic obstructive cardiomyopathy, as an alternative to open heart surgery.[4][10]

In 2002 he succeeded Wilhelm Rutishauser as cardiology chairman at the University of Geneva.[1] He retired in 2006.[3]

Awards

His awards include:[3][4]

Selected publications

Articles

  • Sigwart, U.; Puel, J.; Mirkovitch, V.; Joffre, F.; Kappenberger, L. (19 March 1987). "Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty". The New England Journal of Medicine. 316 (12): 701–706. doi:10.1056/NEJM198703193161201. ISSN 0028-4793. PMID 2950322.
  • Sigwart, U. (22 July 1995). "Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy". Lancet. 346 (8969): 211–214. doi:10.1016/s0140-6736(95)91267-3. ISSN 0140-6736. PMID 7616800. S2CID 32959772.
  • Sigwart, U.; Grbic, M.; Payot, M.; Goy, J.-J.; Essinger, A.; Fischer, A. (1984). "Ischemic Events During Coronary Artery Balloon Obstruction". Silent Myocardial Ischemia. Springer: 29–36. doi:10.1007/978-3-642-69589-6_6. ISBN 978-3-540-13193-9.
  • The SoS Investigators: Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomised controlled trial. Lancet 2002;360:965–970

Books

  • U. Sigwart Automation in Cardiac Diagnosis: The Computer-Assisted Acquisition of Cardiac Catheterization Data, Schwabe 1978,
  • U. Sigwart and P. H. Heintzen (Editors): Ventricular Wall Motion, Thieme 1984,
  • U. Sigwart and G. I. Frank (Editors): Coronary Stents, Springer 1992 (ISBN 9780387545417) (Coronary Stents)
  • U. Sigwart: Endoluminal Stenting, W. B. Saunders 1996 (ISBN 9780702020469) (Endoluminal Stenting)
  • Ulrich Sigwart, Michel Bertrand, Patrick W. Serruys (Editors): Handbook on Cardiovascular Interventions, Churchill Livingstone, 1996

References

  1. ^ a b c d e f g h Rutishauser, Wilhelm (February 2010). "CardioPulse Articles". European Heart Journal. 31 (4): 383–389. doi:10.1093/eurheartj/ehp578.
  2. ^ a b c d e King, Spencer B. (June 2008). "Ulrich Sigwart". Clinical Cardiology. 31 (6): 281–282. doi:10.1002/clc.20322. PMC 6653442. PMID 18543311.
  3. ^ a b c d e f "Ulrich Sigwart". Cardiovascular News. BIBA Medical. 22 November 2011. Archived from the original on 23 October 2022. Retrieved 23 October 2022.
  4. ^ a b c Puel, J. (2005). "Ulrich Sigwart". In Thomas, Adrian M. K.; Banerjee, Arpan K.; Busch, Uwe (eds.). Classic Papers in Modern Diagnostic Radiology. Springer. p. 531. ISBN 3-540-21927-7.
  5. ^ Mark, Allyn (2020). "6. Pioneers of coronary stenting". Pioneers Who Transformed Coronary Disease: From Eisenhower's Heart Attack to Clinton's Coronary Surgery and Stents. Bloomington: AuthorHouse. p. 127. ISBN 978-1-7283-6959-4.
  6. ^ Towers, Malcolm; Davies, Simon (2000). "11. Cardiac catheterisation". In Silverman, Mark E.; Fleming, Peter R.; Hollman, Arthur; Julian, Desmond G.; Krikler, Dennis M. (eds.). British Cardiology in the 20th Century. Springer. p. 151. ISBN 978-1-4471-1199-3.
  7. ^ Jiang, Wei; Zhao, Wenxiang; Zhou, Tianfeng; Wang, Liang; Qiu, Tianyang (16 January 2022). "A Review on Manufacturing and Post-Processing Technology of Vascular Stents". Micromachines. 13 (1): 140. doi:10.3390/mi13010140. ISSN 2072-666X. PMC 8778070. PMID 35056305.
  8. ^ Barton, Matthias; Grüntzig, Johannes; Husmann, Marc; Rösch, Josef (29 December 2014). "Balloon Angioplasty – The Legacy of Andreas Grüntzig, M.D. (1939–1985)". Frontiers in Cardiovascular Medicine. 1: 15. doi:10.3389/fcvm.2014.00015. ISSN 2297-055X. PMC 4671350. PMID 26664865.
  9. ^ Widimsky', 'Petr (17 Apr 2007). "Thirty years of interventional cardiology". www.escardio.org. European Society of Cardiology.
  10. ^ Knight, Charles J. (1 March 2000). "Five years of percutaneous transluminal septal myocardial ablation". Heart. 83 (3): 255–256. doi:10.1136/heart.83.3.255. ISSN 1355-6037. PMC 1729343. PMID 10677397.
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