Professor Igor Gregorič, a top Slovenian heart surgeon from Houston

January 2011

‘Knowledge counts, the patients we help count, relationships count,’ says Professor Igor Gregorič, Director of Mechanical Circulatory Support and Associate Chief of the Transplant Service at the Texas Heart Institute. But to this Slovene, a graduate of Ljubljana Faculty of Medicine who moved to the United States 26 years ago to widen and deepen his knowledge, titles in reality mean very little. If one had asked him, when he made his ‘temporary’ move from Slovenia (‘I wasn’t planning to stay’), whether he was prepared to work 12 hours a day – on a voluntary basis at the beginning – or to give up his holidays, or to learn and pass on the fruits of that learning to students, he would not have hesitated to say yes.

The doctor’s mission is to help his fellow man

Today, when he occupies such a top position, his answer is the same: he has not had a holiday for 20 years, and has passed on his knowledge not only to his young American colleagues but also to some 500 young Slovenian doctors. And even more importantly: to at least as many he has tried to communicate and pass on his own principles regarding the correct ethical relationship to the patient.

The future is in ‘mechanical support’

Prof. Igor Gregorič. Photo: Šimen Zupančič

Prof. Gregorič is a man and a professional who brings a great deal of knowledge to his vocation and spends a great deal of time carrying out research that will benefit patients. ‘In the medium to long term, the future for the treatment of heart disease lies in stem cell treatment, but the research is still at the early stages. They began to build aircraft in the 19th century, but it was only at the beginning of the 20th century that they were made to fly. At that time, everyone was saying it wasn’t possible. Stem cells are, I believe, at that stage now – these babies have only just started to walk (smiles). In the medium term, however …’

Then, he says, heart surgery as we know it today will probably no longer exist. ‘We shouldn’t forget that heart surgery has only been around for 50 years. We have therefore seen the ascension, summit and now something of a decline in certain branches of heart surgery. In 50 years’ time, the public and doctors will probably be asking themselves what things were like today; and it would be great to see what things will be like then’ (smiles).

Treating the heart means finding new methods of treatment, he says. ‘Technology has advanced greatly and the flow of information is extraordinary. My area is heart disease, which is a very advanced disease, the last stage, and that’s where my main surgical interest lies, in my research and my clinical work. In the next 20 or 30 years, I believe that mechanical support will be used in this particular area of cardiology.’ What about artificial hearts? ‘Mechanical support is only an additional support to the human heart; an artificial heart means replacement of the human heart. I work in both areas, although an artificial heart is used very, very rarely: the technology has advanced, but the results of clinical research (our institute is one of the leading artificial heart centres) have not been positive. The range of patients that would need an artificial heart is very small and the industry, for financial reasons, cannot invest a great deal in it. Mechanical support, on the other hand, is growing rapidly. Five years ago there were around 1,500 auxiliary pumps installed around the world helping patients with a weak heart: The first generation had primitive technology, the second was already more advanced and gave results that were twice as positive. Today, survival using the third generation of pumps is 90% in six months. This means that the results are getting closer to those obtained with transplantation. These pumps are getting smaller and easier to insert into the chest cavity, and the results are getting better. This method is, until other methods are developed, one of the best for patients in the last stage of heart disease.

Text by Miša Čermak; full text:  Sinfo, January 2011