The death of René Gerónimo Favaloro on 29 July 2000, at the age of 77, leaves a void in the field of cardiovascular surgery: we have lost one of our most respected and significant contributors. Although he was always hesitant to carry the moniker of “father” of coronary artery bypass surgery, he is the surgeon we should credit with introducing coronary bypass surgery into the clinical arena. Indeed, Dr. Favaloro's pioneering contributions to cardiovascular surgery will be an enduring legacy to his homeland of Argentina and to humanity.

Born on 12 July 1923 in La Plata, capital of the province of Buenos Aires, René favaloro would devote much of life to his homeland, helping to improve the quality of health care there. After he received his medical degree in 1949 from La Plata University, many believed that Favaloro would soon develop a career as a distinguished thoracic surgeon. Instead, he decided to fill in for an ailing colleague, who was a country doctor in the small farming community of La Pampa. Favaloro would spend the next 12 years in La Pampa—his social conscience awakened. He educated his patients about preventive medicine, established the first “mobile” blood bank in this area, and built his own operating room, where he trained general and surgical nurses. He later wrote about this period in his life in his book Memoirs of a Country Doctor.

Despite his rewarding work in La Pampa, Dr. Favaloro's interest in thoracic surgery remained keen. In 1962, he went to the Cleveland Clinic, where he worked with Mason Sones, Willem Kolff, and Donald Effler. Favaloro studied the thousands of cineangiograms that Sones had performed. At that time, Sones had documented indirect revascularization in a patient who had undergone surgery with the Vineberg technique 7 years earlier. Although Favaloro and his colleagues would perform this technique on thousands of patients, they were also beginning to investigate the use of saphenous vein grafts for direct revascularization. Previously, the saphenous vein had been used only for patch reconstruction of occluded coronary arteries, but the technique had a high rate of postoperative thrombosis and was eventually discontinued.

Favaloro reasoned that an alternative method of reconstruction would be to use the saphenous vein to connect the unoccluded proximal and distal sections of the vessels, thus bypassing the obstruction. On 9 May 1967, Favaloro performed the first documented saphenous aortocoronary bypass, in a 51-year-old woman with total occlusion of the proximal third of the right coronary artery. Eight days later, Sones would confirm by angiography that the bypass was patent; 20 days later, angiography showed total reconstruction of the artery. By 1968, Favaloro and his colleagues were combining the revascularization technique with valve replacement and ventricular aneurysmectomy, and performing the first bypasses for acute infarctions.

In 1971, Favaloro returned to Argentina, where he used his knowledge to establish the Favaloro Foundation—a center similar to the Cleveland Clinic's that was based on research, teaching, and clinical activities. The center would provide well-trained surgeons and modern equipment to treat all people, whether they could afford such care or not. He developed an intense educational system that trained surgeons and cardiologists from all over Latin America, who in turn filled positions in Latin American countries that did not previously have this expertise. In later years, it was not unheard of for Favaloro to travel anywhere in Latin America and to come upon at least one of his graduates, further demonstrating that his vision and altruistic actions reached far beyond the walls of the Favaloro Foundation.

Through the years, Dr. Favaloro received many accolades and international awards. He belonged to numerous honorary and scientific societies. In 1992, he received the International Recognition Award at the international meeting of the Cooley Cardiovascular Society, held that year in Puerto Rico. He visited me several times at the Texas Heart Institute beginning in 1960; René was always an incredible inspiration.

As a surgeon, Dr. Favaloro will be remembered for his ingenuity and imagination; but as a man (whose outspoken views on the country that he loved often displeased the Argentine government), he will be remembered for his compassion and selflessness. A well-read student of Latin American history, Favaloro lived what he learned and never forgot the importance of his roots.

I am privileged to have known Dr. Favaloro and to say that he was a friend. He was the first to convince the surgical world that direct revascularization was a way not only of improving the comfort of patients, but of prolonging lives. Subsequently, he has provided cardiovascular surgeons the means to improve the health and quality of life of countless patients throughout the world. I extend our sympathy from the Texas Heart Institute to Dr. Favaloro's family, colleagues, and friends; and to the people of Argentina, who have lost a fervent patriot, a talented surgeon, and a compassionate hero.