Cardiovascular surgery has lost a great man. Manfred Deutsch was not only an esteemed pioneer of heart surgery in Austria, but also internationally renowned for his ground-breaking research. The news of his death drew deeply saddened reactions from around the world. Surgeons of the next generation who lead prestigious departments at Universities, such as San Francisco, Nuremberg, Freiburg or Cape Town are testimony to his profound and enduring mentorship.

Born 10 days after the beginning of World War II in Styria, the heartland of Austria, the privations of the war certainly promoted the occurrence of his severe spinal tuberculosis. Preceding the advent of modern anti-Tb treatment, the remedy of the time was the insufferable isolation at a sanatorium. This early turning point in his life decisively shaped his lifelong deep religiosity, but also strengthened his ability to face great challenges on his own.

After attending medical school in Vienna, he began his clinical career at the 2nd Department of Surgery (“Billroth” Department) at the University of Vienna, shortly after it was taken over by Jan Navratil, who had previously performed the first open-heart surgery in Europe when he was still head of department in Brno. Carried by the incredible ‘can do’ attitude that defined this new discipline, Navratil’s team under Ernst Wolner’s leadership was internationally at the forefront of developing an artificial heart. Manfred Deutsch was part of this team, but also recognized the next trend in cardiac surgery that was already taking shape in the USA. With rheumatic heart disease still prevalent in the post-war era, the initial decade of cardiac surgery had been dominated by heart valve surgery. As the 1960s drew to a close, bypass surgery emerged as a ray of hope for the steadily growing number of patients with coronary artery disease. Manfred Deutsch decided to spend 2 years in Houston with the giants of their time, Denton A. Cooley and Michael DeBakey, who had perfected this new operation. Upon returning to Austria, however, he not only introduced modern coronary bypass surgery but also recognized the potential arising from the unprecedented advances of cardiac surgery for its sister discipline of vascular surgery from aortic arch to sequential crural bypass surgery.

Deutsch wrote history again 10 years later: a new generation of young surgeons had started out under Jan Navratil’s successor Ernst Wolner, all of whom brought several years of basic research experience to their clinical careers. Manfred Deutsch recognized the potential of the group that was pursuing the new field of tissue engineering. He emphatically embraced their cutting-edge research and was the first in the world to implant artificial artery prostheses grown in cell culture. In the course of a few years almost 400 patients received such a tissue-engineered vascular graft convincingly demonstrating the superiority of such hybrid prostheses. As head of cardiovascular surgery, first in Wels and then in Vienna Lainz, he further proved his courageous pioneering spirit by integrating modern cell culture laboratories into the operating theaters thus making it possible to routinely offer the tissue-engineered prostheses to all patients lacking suitable natural bypass conduits like saphenous veins.

Those who knew him were impressed by the high ethical standards he set for himself. Reinforced by his deep religiosity, these standards dominated his patient care throughout his professional life.

His presence as the doyen of cardiovascular surgery had long eclipsed his retirement. His legacy as a surgeon will live on far beyond the borders of his native Austria.

As a friend and mentor, however, he will leave the biggest gap.