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 Vasiliy Kolesov


Born:   September 24, 1904
Deceased:   August 2, 1992

the surgeon, inventor of coronary artery bypass grafting

      

Vasiliy Kolesov was born on September 24, 1904 in a small village of Vologda region. His parents were prosperous peasants and had six children. When Kolesov grew up, he left his home for studying medicine in Leningrad. After graduating from Leningrad Medical Institute in 1931, Vasiliy was distributed to work as a GP in the Chusovoi town of Perm Region. There he met his wife, Ettel Kerstein, who also was a medic. Parents of Vasiliy Kolesov lost their farm and had to move to Chusovoi to their sons place. Son of Vasiliy Kolesov, Eugeniy, was born on June 15, 1935.

Kolesov studied general surgery between 1934 and 1938 at the surgery department, headed by Professor Vasiliy Parin. It was when he fell in love with surgery. Vasiliy Kolesov defended his PhD dissertation Spleen Eventration into Abdominal Wound and moved to Leningrad with his family. In Leningrad the surgeon tried to use bacteriophages to cure infected wounds and planned to defect Doctoral Thesis on that subject, but World War II prevented him from doing it.

After German troops invaded the Soviet Union in 1941, Kolesov was entitled Mayor of Medical Service and was appointed as a head of medical services in one of Leningrad central hospitals. Evacuation of peaceful population took Kolesovs wife and son back to Chusovoi, but Vasiliy left in Leningrad and worked hard to help people during terrible days of blockade. Miserable quantities of food and lack of antibiotics made wounds heal very slowly, so Kolesov tried to prevent infection spread by keeping surgery rooms and hands extremely clean. The surgeon tried to use bacteriophages and saved many lives.

In January 1945, Kolesovs hospital followed the Red Army to Poland. Kolesovs family prepared for another long separation, but Vasiliy unexpectedly agreed to work for Professor Kuprianov in cardio-vascular surgery department of Military Academy of Medicine and stayed with his dear ones. That was the beginning of his career as a cardio-vascular surgeon. In 1946 Kolesov defended his Doctoral Dissertation Bacteriological Control and Treatment of Septic Wounds with Bacteriophages. Kolesov worked in Military Academy of Medicine till 1950 and then spent two years on military service. Retiring in 1953, Kolesov headed surgery department of First Leningrad Medical Institute and held that position till 1976.

In mid-fifties of 20th century, Kolesov learned about an experiment of Demikhov, who successfully used vascular stapler to make end-to-side anastomosis between internal mammary artery (IMA) and coronary artery (CA) of a dog. First experiments of Vasiliy Kolesov on dogs were not successful the technique definitely required improvements. In 1963 Kolesov came across another successful experiment Pronin used a special cannula in order to maintain permanent blood flow through CA during making anastomosis. Kolesov successfully tested the technique and created a special instrument for maintaining continuous coronary autoperfusion. Using modified cannula, Kolesov succeeded in connecting IMA and CA with anastomosis without breaking a blood flow in the CA. Eight dogs, on which the technique was tested, showed anastomosis permeability after 19 months after the operation.

On February 25, 1964, Vasiliy Kolesov made first successful coronary artery bypass grafting on a human being in the world. Through left-side off-pump thoracotomy, left IMA of a working heart was anastomosed with a left circumflex coronary artery. The surgeon used special scissors and optical instruments. That was the beginning of modern coronary surgery.

Coronary
Coronary artery bypass grafting
Soon after that, Vasiliy Kolesov published his first results and the book on direct myocardium revascularization Surgical Treatment of Ischemic Heart Disease. However, despite excellent results of Kolesovs experimental surgery, his innovations werent an easy pill to swallow to medical community of those times.

Vasiliy Kolesov was an evangelist of off-pump coronary artery bypass grafting his team was the first one to use coronary stapling and still holds this title. First ever coronary vascular stapler was called circumferential vascular stapler and was first used during a surgical operation in March 22, 1967.

However, Vasiliy Kolesov continued believing in full arterial revascularization and investigated the possibility of using abdominal arteries as conduits. Medical community understood the benefits of arterial grafts over autovein grafts preserved permeability longer. Another advantage of Kolesovs techniques was that patients after mammary-coronary bypass grafting survived oftener.

In the end of 1970s, Vasiliy Kolesov undertook an assessment of coronary angiograms of patients, which had coronary artery bypass grafting all of them showed excellent permeability and results of functional tests. In 1976 Kolesov published a monograph, dedicated solely to coronary artery bypass grafting.

Even after retirement, Vasiliy Kolesov continued to study long-term results of coronary artery bypass grafting, he read a lecure course to students, enjoyed long walks with his dog and meeting friends. The eminent surgeon was a vey active man his last book came off the press the year before he died. The pioneer of coronary artery bypass, Vasiliy Kolesov died on August 2, 1992, in St. Petersburg.

Today coronary artery bypass grafting is still one of the most frequently performed surgical operations in the world. Permeability of artery grafts is acknowledged to be significantly higher that that of veins. Internal mammary artery is the shunt of choice. Off-pump coronary artery bypass grafting (performed on a beating heart) has many significant advantages over the same operation, but with assisted blood circulation. Rapid development of robot-aided surgery has inspired a renewed interest in coronary stapling. Not everyone could have predicted all this 45 years ago. Vasiliy Kolesov was one of few, who could. Vasiliy Kolesov was the father of modern coronary surgery era, and it is impossible to overestimate the importance of his contribution to medicine.

Source: Astra-Cardio.ru

Kizilova Anna


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