‘A true visionary has passed’: A tribute to Alain Cribier, MD, FACC, FESC
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Key takeaways:
- Alain Cribier, MD, a pioneer of interventional cardiology, has died at age 79 years.
- Cribier was part of a team that performed the first-in-human transcatheter aortic valve replacement in 2002.
G. Alain Cribier, MD, FACC, FESC, long considered a father of interventional cardiology and a mentor to many, died Feb. 16 at age 79 years, the American College of Cardiology announced.
Cribier, who performed the first ballon aortic valvuloplasty in 1985, would go on to perform the first-in-human transcatheter aortic valve replacement on a man, aged 57 years, with severe aortic stenosis who presented in cardiogenic shock in April 2002. The historic moment ushered in a new era of treatment for people with severe aortic stenosis; TAVR is now considered standard of care.
“His legacy extends far beyond the realm of medicine,” Healio | Cardiology Today Editorial Board Member Dipti Itchhaporia, MD, FACC, FESC, the Eric & Sheila Samson Endowed Chair in Cardiovascular Health and director of disease management for Jeffrey M. Carlton Heart and Vascular Institute at Hoag Memorial Hospital, Newport Beach, California, clinical professor of medicine at University of California, Irvine, and past president of the ACC, said in an interview. “He leaves behind a profound impact on countless lives, forever changed not only by his pioneering spirit but his unwavering contributions to excellence. His memory will live on in the hearts of those he touched. His legacy serves as a reminder of the profound difference one person can make in the world. He will be deeply missed.”
In an interview with Healio, Cribier recalled a sleepless night before performing that first TAVR procedure. The patient had major left ventricular dysfunction, an ejection fraction of just 12% and multiple comorbidities contraindicating surgery. After a failed balloon aortic valvuloplasty, TAVR, also known as transcatheter aortic valve implantation (TAVI), was the patient’s only option, Cribier recalled.
“When I started the case, I was extremely worried,” Cribier told Healio in 2022. “I thought it was a mistake to put this patient on the table as the first study case, because he was doing so poorly. He had all of the contraindications for TAVI. I had to announce to my partners that we had this very bad case and I was proposing to do the TAVI on him because he would die. When I saw him on the day, I was very pessimistic. I said, ‘He’ll never be able to make it.’”
The procedure was successfully performed using a challenging approach: the antegrade transseptal approach via the femoral vein. The transcatheter heart valve was accurately deployed in the middle of the valvular calcification.
“After the case, we watched the clock,” Cribier said. “We decided if the patient survived for 30 minutes, we would say the procedure was a success. In 30 minutes, the patient was smiling, moving his hands, thanking everyone for what we did. Five hours later, we drank champagne in his room. It was the beginning of the story.”
Michael J. Reardon, MD, FACC, the Allison Family Distinguished Chair of Cardiovascular Research and professor of cardiovascular surgery at Houston Methodist Hospital, described how Cribier’s contributions impacted not only interventional cardiology, for the better, but also cardiac surgery.
“Surgical aortic valve replacement is undoubtedly one of the most successful surgical operations ever invented for any cardiac disease,” Reardon, who learned of Cribier’s passing while participating in a weekend TAVR panel discussion, told Healio. “Alain Cribier took that most successful operation and improved on it by developing transcatheter valve implantation. In the process of improving this, he has improved the field of surgery. Surgeons have learned to conduct better evaluations and the need to put in better valves to compete with TAVR valves.”
B. Hadley Wilson, MD, FACC, president of ACC, executive vice chair of Sanger Heart & Vascular Institute/Atrium Health and clinical professor at Wake Forest University School of Medicine, called Cribier a father of structural heart intervention.
“From the first days of balloon aortic valvuloplasty nearly 40 years ago, through the first-in-human transcatheter valve therapy 20 years ago, until current times where TAVR is the standard of care along with team-based care, the father of structural heart intervention remained humble and committed to his colleagues and the betterment of patient care,” Wilson told Healio. “A true visionary has passed.”
In a statement posted on their website, the ACC noted Cribier’s cardiology career began in the 1960s, when he opted for a career in medicine over that of a concert pianist, according to a March 2022 feature in ACC's Cardiology magazine. He became fascinated with cardiac surgery at the University of Paris and subsequently worked in the cardiac catheterization laboratory at Charles Nicolle Hospital, the main site of Rouen University Hospital, according to the article. He spent most of his career at Rouen until his death.
In 2022, Itchhaporia, then president of ACC, awarded Cribier the Presidential Citation for his contribution to the development of TAVR. Cribier, emotional as he received the award, was deeply honored, Itchhaporia recalled.
“As a pioneer behind the very first TAVR procedure, his vision, skill, unwavering dedication to advancing CV care, that’s why he received the citation,” Itchhaporia told Healio. “He was really touched by that, to be recognized in such a way. His legacy will endure as a testament to the power of ingenuity and for transforming modern medicine. His contributions really were that large.”
Two decades after performing the first TAVR, Cribier said innovations will continue, perhaps with indications for asymptomatic patients with aortic stenosis. He continued to mentor up-and-coming interventional cardiologists and participate in panel discussions at conferences, always giving credit to his team that helped make the procedure a success.
“People who are truly great never have to tell you they’re great,” Reardon told Healio. “It is obvious. Alain never bragged about what he did; never made a big deal about his role as a father of TAVI. When surgeons like me got involved, he treated me like one of his partners. We obviously had differing opinions, but he was very kind and open. He was willing to spend the time to become a good TAVI physician. He is a man that I look to as someone I would want to pattern myself after.”
Reference:
- ACC. In Memoriam: Alain Cribier, MD, FACC. Available at: https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/17/20/37/In-Memoriam-Alain-Cribier. Accessed Feb. 19, 2023.
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