Forged in conflict: how wars and crises shaped cardiovascular surgery

Wars and crises have historically acted as powerful catalysts for advances in cardiovascular surgery. Throughout the twentieth and twenty-first centuries, periods of armed conflict and global emergencies have driven surgical innovation, accelerated technological development, and reshaped clinical priorities. This review explores how wartime conditions, with their urgent need for effective treatment of vascular and cardiac injuries, fostered the emergence of new techniques such as arterial repair, cardiopulmonary bypass, and heart valve replacement. It also examines how public health crises, including the coronavirus disease 2019 (COVID-19) pandemic, further transformed cardiovascular surgical practice by introducing new protocols, technologies, and logistical frameworks. Drawing on historical milestones, surgical breakthroughs, and lessons learned under extreme conditions, this article highlights the enduring impact of crises on the evolution of cardiovascular surgery and reflects on how these experiences continue to influence contemporary surgical strategies.