After the saphenous vein bypass procedure was extended to include the left arterial system by Johnson, the use of the IMA for bypass grafting was performed by Bailey and Hirose in 1968. Shortly hereafter, Favaloro began to use the saphenous vein as a bypassing conduit. In his physiologic approach in the surgical management of coronary artery disease, Favaloro and his team initially used a saphenous vein autograft to bypass a stenosis of the right coronary artery. The bypass graft technique as we know today was developed by Favaloro in 1967. Still it was not until 1960 when the first successful human coronary artery bypass surgery was performed by Goetz and Rohman, who used the IMA as the donor vessel for anastomosis to the right coronary artery. The major breakthrough in surgery, however, was the invention of the heart-lung machine in 1953, which allowed surgeons to perform open-heart procedures on a non-beating heart and controlled operating field while protecting other vital organs. This technique was the first intervention documented to increase myocardial perfusion and was successfully performed in over 5,000 patients between 1950 till 1970. In 1946, the Vineberg procedure was introduced in which the internal mammary artery (IMA) was used to implant directly into the left ventricular and is hence considered the forerunner of coronary artery bypass grafting (CABG). Later, Beck also developed another revascularization technique by anastomosis between the aorta and the coronary sinus. A pioneer in this field is Beck, a surgeon who in 1935 developed an indirect technique of myocardial revascularization by grafting a flap of the pectoralis muscle over the exposed epicardium to create new blood supply. The concept of surgical revascularization for coronary artery disease (CAD) originated in the early 20 th century. The galleon trade had a negative effect on economic development in the Philippines, since virtually all Spanish capital was devoted to speculation in Chinese goods.1.1. The Spaniards in Manila came to depend on the annual vessel so much that when a ship went down at sea or was captured by English pirates, the colony was plunged into economic depression. On its return voyage, the vessel brought back huge quantities of Mexican silver and church personnel bearing communications from Spain. After unloading at Acapulco, this cargo normally yielded a profit of 100–300 percent. Though Chinese silk was by far the most important cargo, other exotic goods, such as perfumes, porcelain, cotton fabric (from India), and precious stones, were also transshipped via the galleon. They were the sole means of communication between Spain and its Philippine colony and served as an economic lifeline for the Spaniards in Manila.ĭuring the heyday of the galleon trade, Manila became one of the world’s great ports, serving as a focus for trade between China and Europe. Manila galleon, Spanish sailing vessel that made an annual round trip (one vessel per year) across the Pacific between Manila, in the Philippines, and Acapulco, in present Mexico, during the period 1565–1815.
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