George J. Reul, MD: A Tribute

George J. Reul died on March 27, 2025, after a courageous battle of many months with severe chronic illness. George was a pioneer of The Texas Heart Institute for 5 decades and a world-renowned surgeon. He was a remarkable individual with many talents: a master technician, an inquisitive researcher, a mentor to many surgeons, a devoted family man, and a good friend. In addition to his tireless work ethic and relentless pursuit of medical knowledge, George had a broad interest in history; art; listening to music of all genres, especially opera; Formula 1 racing; and world travel. George and his wife, Susie, enjoyed relaxing at their vacation house in Maui each summer as well as the unpretentious lifestyle this afforded. The authors of this editorial knew him well and benefited from his friendship, expertise, and counsel.

George was born in Milwaukee, Wisconsin, on April 19, 1937. He attended Marquette University and completed his undergraduate and medical degrees in 1962. He interned at the University of Chicago Clinic, then pursued his surgery residency at the Medical College of Wisconsin. His residency was interrupted by the draft in 1966, when he served as a captain in the US Army and a trauma surgeon at the Evacuation Hospital in Vietnam. After returning home, George completed his training in general surgery in 1969 and received a master's degree in medical science for his research on thyroid function. He pursued further training in thoracic and cardiovascular surgery at Baylor College of Medicine under Michael DeBakey, MD, and joined the Baylor faculty as associate chief of surgery at Ben Taub County Hospital in 1971.

George J. Reul, MD

George held academic positions as a clinical professor of surgery at Baylor College of Medicine and the University of Texas Medical School at Houston as well as surgical staff appointments at St Luke's Episcopal Hospital, The Texas Heart Institute, Texas Children's Hospital, and Ben Taub Hospital until his retirement in 2014. In 1973, he was invited to join the cardiovascular surgical staff of The Texas Heart Institute under the leadership of Denton Cooley, MD. In 1983, George was named associate chief of surgery and chief of vascular surgery at The Texas Heart Institute. His surgical career encompassed 3 distinct specialty areas involving pediatric and adult heart disease as well as vascular disease during a period of exponential advances in knowledge and treatment of these disorders. His contributions to the development of each field are widely recognized.

George is remembered for his exceptional surgical skill, his tireless work ethic, his calm and focused demeanor in the operating room, and his warm personality. He was remarkably humble, never critical of others, but always in command of the operation, even in adverse circumstances. He displayed a subtle wit and wisdom in his comments, the so-called “Golden Reul.” He was admired by all who worked with him and for the excellent outcomes he achieved for his patients. This success led to many referrals from cardiologists locally and around the world. It is reported that he operated on 15,000 patients, but this estimate may be low. As chief of vascular surgery at The Texas Heart Institute, George developed an outstanding training program for residents. He and his wife, Susie, started the first vascular laboratory at St Luke's Episcopal Hospital, which is named for them today. With the large number of vascular procedures performed each year at The Texas Heart Institute, the program was one of the last to grant combined training in vascular and cardiothoracic surgery for accreditation.

George was admired as a trusted mentor to hundreds of surgeons. He demonstrated the best surgical skills and behavior, with a technical approach much like Dr Cooley's, focusing on simple, straightforward, timely repairs. His teaching method was clear and concise. Many of his trainees have gone on to become international leaders in cardiovascular surgery. His results were superb, even with the most complicated cases. When we examined the risk of mortality with redo coronary artery bypass procedures, we found there was no increased risk for George's patients compared with the first operation. With increasing recognition of his surgical talent, George was asked as a visiting professor to perform surgery at 17 centers in 11 countries, including Egypt, China, India, and Croatia. Dr Cooper accompanied him on several of these expeditions and was always impressed with his scientific yet practical approach to patient care. Dr Cooper observed that “George demonstrated a remarkable ability to think on his feet and adjust when presented with an unknown or undiagnosed or unanticipated problem. Of all the patients cared for by George Reul during those times, not one was lost by him on any trip, an extraordinary record.”

As a reflection of his inquisitive nature and profound work ethic, George was the author and coauthor of more than 250 publications and presented more than 500 lectures on a range of topics in congenital heart disease and adult cardiac and vascular disease. Here are just a few of his landmark publications:

• “Early experience with coronary artery bypass in 640 patients” (1973)

• “First report of ischemic contracture of hypertrophied heart, so-called ‘stone heart’” (1972)

• “Methods to prevent stone heart with propranolol and hypothermia” (1976)

• “Coronary bypass after unsuccessful percutaneous transluminal coronary angioplasty” (1984)

• “Analysis of Ionescu-Shiley valve failure in 2,680 patients” (1985)

• “Sinus of Valsalva aneurysm or fistula” (1999)

He made many contributions in vascular surgery:

• “Long-term result of direct vertebral artery operation” (1984)

• “Management of failed aortofemoral bypass” (1985)

• “Effect of coronary bypass on peripheral vascular operations in 1,093 patients” (1986)

• “Management of vascular graft infections; aortoduodenal fistula” (1987)

• “Distal arteriovenous fistula in lower extremity bypass to enhance perfusion” (1992)

• “Late results of brachiocephalic bypass and stents” (2005)

In addition, he made many contributions to congenital research:

• “Surgical treatment of congenital atrial dysrhythmias” (1984)

• “Congenital malformation of the coronary arteries” (1992)

• “Primary cardiac tumors in infants and children” (1996)

• “Creation of systemic-to-pulmonary artery shunt by use of the internal mammary artery” (1993)

George received numerous prestigious awards throughout his career. He was named an honorary consulting professor of thoracic surgery at the Shanghai Second Medical College and an honorary fellow of the Indian Association of Cardiothoracic Surgery and the Adriatic Vascular Society. He was an alumnus of the year for the Medical College of Wisconsin. He received the Master Clinician Award at St Luke's Hospital and was awarded Distinguished Physician of The Texas Heart Institute. He was given the Lifetime Achievement Award of the International Society of Endovascular Specialists. In addition, he received the Ray C. Fish Award for Scientific Achievement, the highest honor The Texas Heart Institute bestows. Despite these notable honors and awards, George would tell you his greatest accomplishment and reward for a life of service to others is his family. He was a devoted husband to his beloved wife, Susie, and the proud father to 6 sons (George Jr, Ross, David, Darren, Thomas, and John) and grandfather to 8 grandchildren. George's legacy in cardiovascular surgery will live on through the careers of his son, Dr Ross Reul, an outstanding cardiac surgeon, and his grandson, Dr Michael Reul, who is completing his residency training in cardiothoracic surgery. George Reul will be remembered for his character, his example of a truly honorable man, his humility and wisdom, his devotion to family, and his friendship. We are all blessed to have known him.

Reul family surgeons (left to right): Michael, George, and Ross