David Paul Taggart (1958-2026): In MemoriamSurgeon-scientist, patient advocate, and friend

The death of David Paul Taggart on August 8, 2026, at the age of 68, has deprived cardiovascular surgery of one of its most original, courageous and impactful voices. It has also deprived us both of a longstanding academic partner and friend. David was an outstanding surgeon and clinical investigator, and a relentless advocate for scientific truth who put the interests of the patient above all other considerations. David Taggart was born in Glasgow on July 1, 1958 and grew up in Scotland, with his seven siblings in a close-knit family. He studied medicine at the University of Glasgow, qualifying in 1981. His postgraduate training took him through Glasgow, Paris, Newcastle and London, including the Royal Brompton Hospital, where he trained under Sir Magdi Yacoub and Mr Christopher Lincoln; he often spoke fondly of their mentorship. He received an MD with Honours in 1989 and completed a PhD at the University of Strathclyde in 2000. In 1995 he was appointed Consultant Cardiothoracic Surgeon at Oxford’s John Radcliffe Hospital; in 2004 he became Professor of Cardiovascular Surgery at the University of Oxford. During his long and happy Oxford career, Professor Taggart—often simply called “Prof” by his many students, mentees and colleagues—conducted or participated in more than 20 original studies and clinical trials and authored more than 350 peer-reviewed publications. He served as President of the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) from 2010 to 2012. Although he is best known as a global expert on surgical coronary revascularization, Taggart’s early research revealed a broad intellectual curiosity in numerous areas of cardiac surgical physiology and pathophysiology. He examined hypothermia and the metabolic, endocrine and acute-phase responses to cardiopulmonary bypass and investigated postoperative respiratory dysfunction, attempting to distinguish the contributions of cardiopulmonary bypass from those of bilateral internal thoracic artery harvesting. His PhD thesis explored whether antagonism of platelet-activating factor could ameliorate the myocardial, pulmonary and cerebral consequences of cardiac surgery. Later studies led by Taggart included biochemical assessment of myocardial injury, a randomized investigation of postoperative lung injury and a randomized neuroprotection trial. Even when interventions were not consistently beneficial, Taggart published those negative findings, demonstrating his firm belief in the importance of randomized trials to provide evidence for cardiac surgical procedures. In the middle of his career, Taggart began to focus on advancing the state of the art in coronary bypass surgery. His 2001 systematic review of largely observational data found a substantial survival advantage associated with bilateral rather than single internal mammary artery grafting.1 This prompted him to build a multidisciplinary collaborative team to undertake the difficult task of testing the hypothesis prospectively. The result was the Arterial Revascularisation Trial (ART), which he conceived with the late Douglas Altman, to compare mortality rates between coronary artery bypass graft surgery (CABG) using standard single internal thoracic artery grafts versus bilateral internal thoracic artery grafts in a randomized controlled trial. The grant application for ART to the UK Medical Research Council and British Heart Foundation was successful, and £3.4 million (about 5 million US dollars at the time) was awarded to Taggart, the University of Oxford and the Clinical Trials and Evaluation Unit at Royal Brompton Hospital, London. Between 2004 and 2007, 3102 patients were randomized at 28 cardiac surgery sites in 7 countries to single or bilateral internal thoracic artery CABG surgery with vein grafts. Enrolment into the trial was consistently ahead of schedule which was a tribute to Taggart’s leadership and ability to convene a group of enthusiastic cardiac surgeons to participate in the trial. Clinical follow-up and data analysis have continued through 15 years, during which David partnered closely with Oxford cardiologist Marcus Flather to lead the analytic team. An interim 5-year report,2 the primary outcome report at 10 years3 and the most recent 15-year follow-up report4 were consistent and showed that for the intention-to-treat analysis there was no difference in mortality rates between the two strategies. For the secondary composite outcome of death, myocardial infarction and stroke there was a slight numerical advantage for the bilateral approach, but this was not statistically significant. Interpretation was complicated by important treatment crossovers: approximately 14% of patients assigned to bilateral grafting received only one internal thoracic artery, while approximately 22% assigned to single grafting received a radial artery as a second arterial conduit. David presented the 15-year ART results at the American Association for Thoracic Surgery meeting in May 2026. The intention-to-treat comparison remained neutral, whereas the as-treated analysis again associated actual receipt of multiple arterial grafts with significantly lower mortality. ART is an important trial because observational studies have consistently shown that bilateral internal thoracic artery grafts are associated with lower mortality compared to standard single internal thoracic artery grafts, but these studies are often confounded by unbalanced covariates like age and gender which may introduce bias in spite of statistical adjustments. Taggart was one of the pioneers of multiple arterial graft CABG and many of his operations included bilateral internal thoracic artery grafts carried out using off-pump techniques. He personally enrolled more than 400 patients in ART and his own results demonstrated about 15% proportional mortality reduction with the bilateral approach—an observation that he was proud of even if it did not change the trial’s overall conclusion. Taggart’s body of work included several studies of off-pump CABG. He was an investigator and co-author in the international CORONARY trial,5 the largest randomized comparison of on-pump and off-pump CABG. His subsequent ART sub-analyses clearly demonstrated that off-pump surgery can achieve excellent outcomes, but its success is highly dependent upon operator experience. In ART, low-volume off-pump surgeons performed fewer grafts, converted to cardiopulmonary bypass more frequently and had worse patient outcomes.6 He also investigated methods of improving the performance of saphenous-vein grafts. The VEST programme evaluated whether external stenting could reduce adverse remodelling, lumen irregularity and diffuse intimal hyperplasia. The first randomized study showed reduced intimal hyperplasia area at 1 year, and subsequent multicentre work demonstrated improved FitzGibbon patency classification and reduced intimal thickening at 2 years, although a definitive clinical benefit remained unproven.7 Taggart also brought his evidence-based approach to intraoperative assessment of graft quality, with the prospective, multicentre REQUEST registry, in which protocol-based transit-time flow measurement and high-frequency epicardial and epi-aortic ultrasonography were used in 1016 patients undergoing CABG. Intraoperative assessment prompted a change in the planned operative strategy in 25.2% of patients, including graft revision in 7.8% of patients. This project reflected Taggart’s belief that the technical quality of coronary bypass surgery should be objectively measured and verified rather than presumed at the conclusion of every CABG operation.8 The rise of percutaneous coronary intervention (PCI) in the 1990s and early 2000s saw a corresponding decline in CABG numbers globally. Taggart was very concerned about this, not because he was worried about becoming an “extinct” cardiac surgeon but because he felt that patients were being sold short with incorrect treatment decisions in favour of PCI when treating symptomatic coronary artery disease (CAD). He expressed concerns that cardiac surgeons were being left out of the decision-making process, where the interventional cardiologist would often assess the patient and advise PCI treatment without wider consultation. His efforts, and the efforts of others, led to the concept of the “heart team” approach, whereby patients with advanced or complex CAD would be discussed in a multidisciplinary team meeting with cardiologists, cardiac surgeons and other experts to provide the best treatment strategy. Reports that pooled individual patient data from the randomized trials of PCI vs CABG for symptomatic CAD consistently showed survival advantages for CABG in patients with complex CAD, including diabetes. These results shaped the revascularisation guidelines from the European Society of Cardiology (ESC) and the European Association of Cardiac and Thoracic Surgeons (EACTS) and undoubtedly allowed patients more appropriate access to CABG. Taggart was a popular speaker on this topic at international meetings, and his command of the relevant data and his fearless ability to push back against the tide of popular opinion was legendary. Taggart’s invited Ferguson Lecture at the Society of Thoracic Surgeons meeting in 2006 bore a title that broadcast his deeply held conviction: “Coronary artery bypass grafting is still the best treatment for multivessel and left main disease, but patients need to know.”9 Taggart was also well known, even notorious in some circles, for his fallout with the EXCEL study group, which conducted a large randomized controlled trial comparing PCI versus CABG in patients with left main CAD. When the 5-year results were being analysed, Taggart pointed out that mortality rates were higher in the PCI group and felt that the manuscript should emphasize the mortality outcome, but was voted down. Taggart also felt that the Universal Definition for perioperative MI should be reported in a sensitivity analysis as prespecified, and that the difference in definition of perioperative MI had effectively tilted the composite primary endpoint in favour of PCI; this was later shown to be mathematically true.10 He ultimately resigned from the EXCEL Steering Committee and took his name off the author list. This became a widely reported issue, with the New England Journal of Medicine requesting clarifications and the BBC launching an independent investigation of the data.11 This episode underscored Taggart’s trademark determination to seek the truth for patients and ensure that information is shared transparently with the scientific and clinical community. The eventual ESC/EACTS reassessment concluded that, among low-surgical-risk patients with left-main anatomy suitable for either treatment, both CABG and PCI were clinically reasonable, while proposing Class I, Level A support for CABG and Class IIa, Level A support for PCI. This controversy did nothing to diminish Taggart’s advocacy for the multidisciplinary Heart Team approach to coronary care. His commitment to ethical partnership between cardiac surgeons and cardiologists was recognized by the leadership of Transcatheter Therapeutics Asia-Pacific (TCTAP) in granting David Taggart the Master of Masters award in 2026, the first time a surgeon has ever received this prestigious award. In 2015, Taggart and Puskas co-founded the International Coronary Congress (ICC), and subsequently the International Society for Coronary Artery Surgery (https://internationalcoronarycongress.com). Now in its 12th year, ICC is the only annual international scientific meeting entirely devoted to advancing the state of the art in surgical coronary revascularization and has been attended by more than 10 000 cumulative delegates from more than 50 countries. From the inaugural meeting in 2015, Taggart delivered numerous lectures at each ICC meeting, engaged in many collegial debates and panel discussions and earned legions of admirers and friends from among his international coronary surgical colleagues. He was especially proud of having co-founded the International Coronary Congress; Taggart was an academic globalist who viewed world-class coronary surgery as something that should be available around the world. Moreover, he was convinced that coronary surgeons in all parts of the world could best advance the state of the art in coronary surgery by working and learning together. Taggart and Puskas created and personally funded the ICC Founders’ Fellowship to help defray the costs of attendance at each annual ICC meeting for young coronary surgical trainees and junior faculty; it has now been renamed the David Taggart Memorial Founders’ Fellowship. Taggart was immediately recognizable at the ICC or any other scientific meeting in his customary Oxford shirt and denim jeans, without a jacket or tie (Figure 1). David Taggart and John Puskas at the Inaugural Meeting of the International Coronary Congress, New York City, 2015. David Taggart was a tireless educator in coronary surgery globally and travelled the world delivering hundreds of invited lectures. He was a generous mentor to dozens of trainees and hundreds of colleagues worldwide. Also with Puskas, Taggart conceived and co-edited the 2021 Oxford University Press textbook entitled “State-of-the-Art Surgical Coronary Revascularization,” the first and only major textbook devoted solely to every nuance of surgical coronary revascularization.12 Taggart had many interests outside of cardiac surgery. He had an encyclopaedic knowledge of contemporary art. He loved sailing in the Mediterranean, snowboarding in the Alps, appreciated a good pub anywhere and possessed a mischievous sense of humour. In June 2026, only weeks before his death, he married Kathleen Hargreaves, his life partner, in an elegant ceremony in the Cotswolds, England. After a Mediterranean honeymoon, Taggart lectured in Asia in July 2026. Typical of David’s self-determination, he continued to live and to work as he saw fit, without breaking stride, despite his terminal illness. David Taggart’s greatest professional legacy is not an operation, conduit, clinical trial or controversy. It is an attitude towards our profession: surgeons must generate evidence rather than merely invoke experience; difficult improvements should not be dismissed because they require advanced training; important negative results deserve publication; and allegiance to institutions, specialties and even professional colleagues must remain subordinate to allegiance to our patients. He was a genuinely honest and honourable professional colleague. He was a tremendously productive academic partner for more than 20 years for each of us and a close friend to us both. We will miss him dearly. Godspeed, David Taggart. None declared. None declared. AI was used to confirm the accuracy of references and dates.