Memorial address for Carlos M. G. Duran, M.D., Ph.D.

Prof. Carlos G. Duran (Fig 1) passed away on his 85th birthday, June 11th. He and his wife had returned to their family home in Bilbao this spring due to his failing health. Prof. Duran was born in Tetuan, Morocco in 1932 as the son of a Belgian mother and a Spanish father who was a general surgeon. Prof. Duran completed his M.D. at Madrid University in 1956, followed by a residency in General and Thoracic Surgery at the Hopitaux de Paris and then a Ph.D. at Oxford University, with an emphasis on heart valve replacement. His most noteworthy invention was the Duran ring, an annuloplasty system for repair of the mitral and tricuspid valves. He established cardiovascular surgery programs at Navarra University Clinic, Pamplona, Spain, Valdecilla National Medical Center in Santander, Spain, and King Faisal Hospital in Riyadh, Saudi Arabia. He moved to Missoula, Montana, US in 1995 and founded the International Heart Institute of Montana. He was deeply curious, exceedingly generous, and a true scientist–scholar. To his fellows-in-training, Prof. Duran was known to say ‘‘Don’t believe a word I tell you. Challenge everything. This is how medicine advances’’. I met him first at a Mitral Valve Workshop in La Jolla, California in 1988. There were 5 live demonstrations of mitral valve repair and echocardiographic assessment of mitral valve before and after repair. I was very impressed in terms of the teaching style of surgical procedures. I learned ‘‘Flip-Over technique’’ for anterior mitral prolapse there. When I returned to Japan, a 48-year-old lady suffering CHF due to anterior leaflet prolapse was waiting for surgery in the ICU. The patient underwent ‘‘Flip-Over technique’’ with good results. In 1990, I again attended a mitral workshop in Tampa, Florida. There were live demonstrations, lectures, and a wet lab using porcine hearts. Since we had an opportunity to start a clinical trial of the Duran flexible ring in Japan, I learned a lot about size selection and implanting procedure of the Duran flexible ring using a porcine heart. After clinical application of the Duran flexible ring, echocardiographic analysis of the mitral annulus with the Duran flexible ring allowed us to understand the flexibility of the mitral annulus after repair. I wrote the manuscript and faxed it to Prof. Duran in Saudi Arabia. The manuscript was revised in 2 days and I had a call from Carlos. He said ‘‘What do you think about my revision?’’ The manuscript entitled ‘‘Comparison of the Carpentier and Duran Prosthetic Rings Used in Mitral Reconstruction’’ was accepted without revision and was published in1995. Prof. Carlos G. Duran and his colleagues, Dr. J. Oury, Dr. P. Shah, Dr. D. Rubenson organized the Rocky Mountain Valve Symposium. The main theme of the Rocky Mountain Valve Symposium included mitral valve repair, tricuspid repair, aortic valve repair, valve sparing technique, Ross procedure. Live surgeries by Prof. D. Ross, Prof. A. Carpentier, Prof. M. Yacoub and Prof. T. David were very impressive. Prof. Duran taught us the contraindication for mitral valve repair (Table 1). As this concept was the start of my mitral valve repair, I have challenged so many reparative techniques. I have attended the Rocky Mountain Valve Symposium 15 times because of attractive ideas for the management of patients with heart valve disease. The picture is the Rocky Mountain Valve Symposium’s 10th anniversary. You can see the & Yukikatsu Okada [email protected]