What led you to found the Arizona Heart Institute? After completing my general surgery residency, I spent the next 6 years in Houston, Texas, where there were great opportunities to learn cardiac and vascular surgery. However, as time went on, I felt that it would be difficult to achieve some of my goals in that environment and decided to move to Phoenix, Arizona. My thought was that in an area of great growth, like Phoenix, establishing a heart institute would provide my colleagues and I with an opportunity to explore and develop different programs. The concept of combining clinical care, research, and education was attractive in those days, and there was great support. The Arizona Heart Institute offered an opportunity to explore future cardiovascular medicine and surgery without some of the constraints of large university programs.
Please tell us about establishing the nation's first outpatient cardiac catheterization laboratory. Among the concepts we developed early in the program was the establishment of an outpatient cardiac catheterization laboratory. Although it seemed to be a radical approach, the efficiencies, economics, and convenience were all positive reasons to explore this concept. It turned out to be extremely successful. Now, when I look back it does not seem like such a monumental development because even outpatient angioplasty is becoming common around the world. However, to those looking at the idea in the early ‘70s, many thought that we were crazy and irresponsible.
What are some technological advances you expect in the coming year? The field of endovascular therapy is moving at an extremely rapid pace. We have already seen the more advanced technologies related to stent grafting in which the initial concept was limited to the infrarenal abdominal aorta. Now the technology is expanding to the thoracic aorta and also to the treatment of thoracoabdominal aneurysms with endoluminal grafts. The idea of drug-eluting stents is also very exciting, and we can predict that this concept will be explored in almost all of the arterial locations beyond the coronary arteries.
How do you think gene therapy will impact upon endovascular medicine? The mapping of the human genome is extremely important. Already, we are seeing gene therapy being tested in treating both coronary and peripheral arterial disease. This is really just the beginning of a very exciting era. As markers for cardiovascular disease become available, the way that we treat patients will change. The ability to use the genetic makeup for diagnosis, therapeutic decisions, and prognosis is already available to us, but will become common practice in the future. I am also extremely interested in the area of cell technology, and we have already demonstrated the ability to transplant skeletal muscle into the myocardium in patients who have had myocardial infarctions and congestive heart failure. I predict that we will in the very near future combine the use of cells and genes in a variety of different conditions. The whole area of tissue engineering will have a dramatic impact on the endovascular field.
Please tell us about your weekly television appearances. Many years ago, I was approached by the local ABC affiliate with the concept of appearing a couple of times per week during the news segment just before noon. The idea was to bring to the public new ideas about what was going on in heart and blood vessel research and to provide viewers an opportunity to call and ask brief questions. This turned out to be highly successful, and we have done it for 15 years. It is interesting that the “Ask Dr. Diethrich” period of 7 or 8 minutes has become very popular and wherever I go, people will comment that they enjoy the opportunity to call in or listen to the questions that others have.