The history of cardiothoracic surgery at Baylor College of Medicine begins in 1948, when Michael E. DeBakey was recruited as chair of the Department of Surgery. With the addition of Denton A. Cooley, E. Stanley Crawford, and other surgical legends, Baylor College of Medicine quickly rose to the forefront of cardiothoracic surgery. Highlights in its history include treatment of aortic aneurysm and dissection, development of synthetic aortic substitutes, early experience with cardiac replacement valves, the first successful use of coronary artery bypass grafts to revascularize the heart, and the cardiac transplantation and total artificial heart program, which led to the creation of the left ventricular assist device. Baylor's Division of Cardiothoracic Surgery continues to build on its history and legacy to remain a vital contributor to the specialty in the 21st century.