Innovation in healthcare doesn’t happen by accident; it takes vision, execution, and the right people at the helm. Few understand this better than Dr. John Yianni, a seasoned medtech entrepreneur and investor with over 30 years of experience. Having helped pioneer coronary interventions, including the first coated stents that became drug-eluting stents, John continues to lead his own company, CryoTherapeutics, while also supporting the next generation of founders as an investor and Partner at Earlybird Health.

With this dual perspective as both CEO and investor, John brings a rare combination of operational insight, scientific understanding, and strategic foresight. In this conversation, he shares his thoughts on what excites him in medtech, the patterns that separate successful ventures from those that struggle, and how his CEO experience informs his approach as an investor.

Revolutionary Technologies Drive Real Impact

1. What emerging trends or technologies in medtech excite you the most, and how do you see them shaping the next generation of healthcare innovation?

What most catches my attention is a technology addressing a problem in a new or different way, and which can make a massive difference to clinical outcomes, simpler procedures, drastic cost reductions. Preferably, it’s all of those things! Sometimes, it is possible to combine all three.

Focusing on more revolutionary technologies and approaches may seem to be more on the risky side. Often, there is no clear regulatory path for a new technology, so you need to use your experience and your network to assess the risks and hope that the FDA agrees. Not for the fainthearted.

I was involved with developing the first coated coronary stent, which evolved into the drug-eluting stent, at a time when no such devices existed on the market. I was persuading investors that it was a good idea and they should invest. Now I sit on the other side of the table, looking for the next generation of founders with innovations that can truly make a difference.

I'm especially excited about the imaging revolution now underway, powered by AI to better characterize coronary artery disease and enabling therapy.

Non-invasive as well as invasive imaging is already making an impact on interventional cardiology, not just to diagnose disease, but also to provide information to physicians to enable them to decide how best to treat their patients.

This is also impacting the next generation of coronary artery treatment technologies, such as the treatment of vulnerable plaque, to reduce the risk of heart attack. Without the developments in the imaging area and AI to help interpret data, these therapies would just be ideas looking for an application. 

The knock-on effect is that, suddenly, after years of little innovation in coronary intervention, we are seeing more new potential interventional approaches to treating coronary artery disease.

The Four Pillars of Startup Success

2. From your 30+ years in medtech, as a founder/CEO and investor, what patterns separate ventures that succeed from those that struggle?

Number One: The team

The team is important. One can never underestimate or understate the importance of the team. As an investor, I have never backed a first-time team. That’s not to say that I wouldn’t, but it depends on the attitude and pedigree of the founder or CEO. 

An egotistical first-time CEO or founder who thinks they know how to create a successful startup, with their only qualification being that they read the biographies of Steve Jobs and Elon Musk, is a no-go for me. 

When the CEO thinks he/she needs to be the smartest person in the room and hires people less smart than him/her, then you know you have a problem. Having been in the startup field for 30 years, you develop a sixth sense for people.

In my first startup, I was the first employee. But by the time I left (after 12 years) the company was on its fourth CEO and had had its fair share of founder issues. That teaches you a lot about people and getting the right person at the helm as the startup develops and goes through its various stages of development.

Number Two: Investors and the Board 

You need the right syndicate and coinvestors. Companies are ruined by boards and investors who have little experience and no clue about the area in which they have invested. They make ill-judged decisions out of ignorance and based on criteria that inevitably stunt the company’s growth and push it in the wrong direction. It is also important to have independent board members who are sector experts and who can work with the CEO while building a relationship of trust with him/her. This pays dividends when the time comes for M&A.

Number Three: Execution

You can see early on how well a company is executing. If it is executing well, then that’s all fine. However, Boards often let things proceed too long when they should have intervened earlier to help support management or facilitate needed changes. 

It could be getting mentoring for the CEO, hiring the right people at the C-level, and having enough engineers with the right experience. When you are missing targets and milestones, the board can’t just sit around and twiddle their thumbs and do nothing.

Number Four: Having a Crystal Ball

We all want one, but the best crystal ball is your experience. It’s that gut feeling and awareness of new trends that allows you to identify potential future winners early, and also process all the important variables: team, IP, potential regulatory path, how disruptive the technology is, whether this will create a new market, and when you are likely to get an exit. 

Your own internal algorithm can work all this out once you have done it a few times, and your failures are as important as your successes.

The Dual Perspective: CEO and Investor

3. How does your dual perspective as CEO and investor influence evaluation and support of medtech founders?

Being a CEO myself allows me to better understand the stresses and strains that CEO’s have to live with. It also keeps me at the cutting edge of many aspects of the industry. These are insights that feed into my other side as a Venture Capitalist, which I would not have if I were just a VC. The two roles are complementary. 

When I am fundraising for my company, I have pretty good insight into what the person on the other side of the table is seeking.

And when serving on Boards of our investee companies, I can bring a lot of operational insight to the company, based on current practices rather than something I might have experienced 10 or more years ago. A lot has changed in 10 years, and many experienced VCs harp back to what the world was like in a previous era when they were operationally active.

So, I feel blessed I still have this dual perspective and role. For me, it is 2 + 2 = 7 and both Earlybird and my company, CryoTherapeutics, benefit.

John’s journey illustrates what it takes to drive real change in healthcare: a relentless focus on innovation, an ability to spot and nurture exceptional talent, and the discipline to execute with precision. His dual role as both CEO of CryoTherapeutics and investor and Partner at Earlybird Health gives him a unique vantage point, one that bridges the operational realities of building a company with the strategic perspective of identifying and supporting the next generation of innovators.

For founders, investors, and the broader healthcare ecosystem alike, John’s insights highlight the importance of visionary leadership grounded in execution, experience, and a deep understanding of both science and market dynamics.

As the medtech landscape continues to evolve, it is leaders like John, who combine curiosity, expertise, and purpose-driven action, who shape the innovations with the greatest potential to improve patient outcomes and transform healthcare for the better.