Coronary Artery Research
In our work with patients who suffer heart disease from atherosclerosis (hardening of the arteries and the formation of fatty plaques) and heart attacks (a myocardial infarction), our surgeons and researchers are currently investigating the long-term benefits of performing beating-heart surgery, instead of the traditional approach where the heart was stopped and complications from stroke could occur; especially in patients with known risk factors for stroke. Professor Michael Vallely and colleagues published a landmark study of their experience using a ‘no-touch’ technique (anOPCAB) based upon their experience with 37, 720 patients that showed a reduction in stroke of 78% compared to traditional bypass surgery, reduced mortality (50%), less kidney failure (53%), 48% less bleeding problems and a reduction in ICU length of stay. The website has an ABC produced video clip of Professor Vallely operating on a patient using this technique. See: Journal of the American College of Cardiologists, 2017 ‘Coronary artery bypass grafting with and without manipulation of the ascending aorta’.
The Baird Institute is working with researchers at The Charles Perkins Centre to better understand operative challenges for heart and lung surgery and are using the Hybrid Operating Theatre to simulate these challenges. Dr Hugh Paterson recently published a study within this area in Journal of Thoracic Cardiovascular Surgery 2017: ‘Competitive flow in coronary bypass surgery: The roles of fractional flow reserve and arterial graft configuration’.
Clinical Trials, supported by The Baird Institute, at RPAH are contributing to findings nationally and globally to ensure that improved techniques and technology will help patient survival. One such trial is the VISION study, conducted with The St George Institute and Abbott – Diagnostics to investigate blood levels of Troponin, a protein, that might signal early heart muscle damage in surgery.
Exciting new research continues in the field of developing synthetic materials that mimic blood vessels. Dr Wise and colleagues published in Nanomedicine, 2017 ’Plasma activated coating immobilizes apolipoprotein A-I to stainless steel surfaces in its bioactive form and enhances biocompatibility’, recent results from their work in establishing artificial blood vessels that reduce the risk of clotting and act like normal blood vessels. This approach will help surgeons use ‘fake’ blood vessels when the patient’s own vessels are too damaged for use.