These are achievements of the recent past. What advances can we
hope for in the next few years? While nobody can predict the future, there
are certain areas where it is possible to visualise important and exciting
discoveries. Intensive coronary care, for all the benefit it has brought, is still
in a relatively primitive stage of its development. As with many forms of
treatment in the early years of discovery, it is complex and expensive. There
is little doubt that further investigation will lead to the discovery of more
sophisticated machines and new and more effective drugs. This will give us
safer, more effective and cheaper treatment for coronary patients.
Heart surgery too is plainly capable of great developments. The
advances which benefit the coronary patient will also help patients in the
crucial period following a major heart operation, and we can look forward to
a safer and more comfortable after-care. A further leap forward may well
follow a more detailed knowledge of the immune mechanism by which the
body rejects the introduction of foreign tissue. If it could once be overcome,
and a satisfactory system of longterm storage of human tissue developed, a
new chapter would open up for the heart surgeons.
Past experience in the elimination of other killer diseases such as
polio, tuberculosis, smallpox, diphtheria, typhoid and many infectious
illnesses has shown that it is research work in the laboratory that has led to
the understanding of their cause and successful treatment. In coronary
thrombosis it will be intensive work in the laboratory on the causes of blood
coagulation and damaged arteries that will lead us to the solution of the
cause of coronary attacks and their future elimination.