Zhu YY, Seco M, Harris SR, Koullouros M, Ramponi F, Wilson M, Bannon PG, Vallely MP

Bilateral Versus Single Internal Mammary Artery Use in Coronary Artery Bypass Grafting: A Propensity Matched Analysis

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Zhu YY, Seco M, Harris SR, Koullouros M, Ramponi F, Wilson M, Bannon PG, Vallely MP

Heart Lung Circ 2019 May;28(5):807-813

PMID: 30126790

Abstract

BACKGROUND: Bilateral internal mammary artery (BIMA) grafts have demonstrated superior long-term outcomes compared with single internal mammary artery (SIMA) grafts. Despite this, BIMA remains widely underutilised due to perceived technical challenges and concerns regarding wound healing. We sought to examine the morbidity and mortality associated with BIMA use in a propensity-matched cohort of patients.

METHODS: From 2009 to 2016, 3,594 consecutive patients underwent coronary artery bypass surgery at three affiliated institutions. Thirty-day (30) mortality and morbidity data were collected prospectively. Propensity-score matched analyses were performed for BIMA versus SIMA use controlling for a number of preoperative characteristics.

RESULTS: Overall, 29% of procedures were performed off pump, with a greater proportion in the BIMA group (43% vs. 21%, p<0.001). In the propensity-score analysis consisting of 820 matched pairs, there were similar rates of 30-day mortality (1.3% BIMA vs. 0.9% SIMA, p=0.48) and deep sternal wound infection (1.1% BIMA vs. 0.9% SIMA, p=0.84). The rate of superficial sternal wound infection trended towards being higher in the BIMA group (2.6% vs. 1.3%, p=0.077). The rates of red blood cell transfusions (27.4% vs. 27%, p=0.217), other blood product transfusions (18% vs. 20%, p=0.217), and reoperation for bleeding (2.9% vs. 2.1%, p=0.349) were similar.

CONCLUSIONS: Bilateral internal mammary artery use was associated with similar rates of deep sternal wound infection compared to SIMA use, with a preponderance of superficial sternal wound infections that did not result in increased mortality or transfusion requirements. The use of BIMA should be more widely considered for coronary artery bypass surgery.

Repair of Less Than Severe Tricuspid Regurgitation During Left-Sided Valve Surgery: A Meta-Analysis

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Cao JY, Wales KM, Zhao DF, Seco M, Celermajer DS, Bannon PG

Ann. Thorac. Surg. 2020 Mar;109(3):950-958

PMID: 31589849

Abstract

BACKGROUND: This systematic review and meta-analysis was undertaken to investigate the short- and long-term clinical outcomes of concurrent repair of mild or moderate tricuspid regurgitation (TR) during left-sided valve surgery.

METHODS: Medline, PubMed, EMBASE, and Cochrane Libraries were searched, and 12 studies were identified, comprising 1373 patients who underwent TR repair during left-sided valve surgery and 1553 patients who did not. Of these studies, 6 were classified as having a low risk of bias (randomized controlled trials or propensity-matched studies), and 6 were considered as having a high risk of bias (nonmatched observational studies). The primary analysis included only studies with a low risk of bias (399 repair and 426 nonrepair).

RESULTS: Primary analysis of studies at low risk of bias demonstrated that the addition of TR repair compared with nonrepair was associated with reduced risks of cardiovascular mortality, all-cause mortality, and progression of TR over a median of 5.3 years of follow-up (cardiovascular mortality: relative risk [RR], 0.46; 95% confidence interval [CI], 0.28 to 0.75; P = .002; all-cause mortality: RR, 0.68; 95% CI, 0.49 to 0.96; P = .03; and TR progression: RR, 0.26; 95% CI, 0.12 to 0.56; P < .001). Cardiopulmonary bypass time was significantly shorter in the nonrepair group (mean weighted difference, 18 minutes; 95% CI, 6 to 30; P = .003), although the risk of perioperative mortality was comparable between the 2 groups (RR, 0.72; 95% CI, 0.27 to 1.97; P > .05).

CONCLUSIONS: Concurrent repair of mild or moderate TR during left-sided valve surgery is associated with improved long-term clinical outcomes without adversely affecting early survival. Should these results be validated by ongoing trials, there should be a revision of current guidelines to recommend a more aggressive approach toward TR repair.

The Sydney Heart Bank

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The Sydney Heart Bank

The Charles Perkins Centre, The University of Sydney

The Sydney Heart Bank (SHB) is the largest repository of cryopreserved human hearts in the world (17,000 samples). It was established in 1989 by Cris Dos Remedios (Emeritus Professor University of Sydney) and the Late Victor Chang AC (Cardiothoracic surgeon at St. Vincent’s Hospital Sydney). It has been housed and maintained by the University of Sydney since 1989 and it currently resides on campus in state-of-the-art bio-banking facilities at the Charles Perkins Centre, with A/Prof Sean Lal as the Director of the SHB.

Comprised of failing hearts (heart failure) of many different causes, as well as donor hearts (non-diseased hearts) for comparison (control group), the SHB is completely not-for-profit, with the sole mission to foster national and international research collaboration into the causes of heart failure. Today, A/Prof Sean Lal and Professor Paul Bannon, Chair of The Baird Institute, are expanding this biobank to include heart tissue from patients undergoing all forms of cardiac surgery at Royal Prince Alfred Hospital, with the aim to undertake the world’s largest multi-sequencing (gene, protein, enzymes, metabolite) study of human heart failure to-date in collaboration with a team of scientists at the Charles Perkins Centre. This will almost certainly lead to new discoveries as to the pathways that cause heart disease and hence the development of therapies to treat and reverse it.

Click here to access the Sydney Heart Bank information page

Annals of Cardiothoracic Surgery

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Recently The Baird Institute and Royal Prince Alfred Hospital began supporting The Annals of Cardiothoracic Surgery (ISSN 2225-319X), an international bi-monthly peer-reviewed publication, dedicated to the field of cardiothoracic surgery, with the primary aim of providing critical analysis and comprehensive overview of contemporary topics within the field.

The interplay of best clinical evidence, surgical education and global impact makes the Annals of Cardiothoracic Surgery (ACS) the leading contemporary surgical journal, setting it apart from traditional journal formats.

The ACS is proud to announce that it has received its inaugural Impact Factor of 2.895. This excellent result places ACS as the fourth most highly ranked journal dedicated to cardiothoracic surgery. This Journal Impact Factor reflects ACS’ drive for best clinical evidence through comprehensive systematic reviews/meta-analyses in all aspects of cardiovascular and thoracic surgery; a commitment to surgical education through highly-cited keynote lectures, multimedia videos and detailed illustrative articles; and a vision for global impact, achieved by working closely with our esteemed Editors and Authors.

The Editor-in-Chief, Professor Tristan Yan, commented recently, “We look forward to continuing our work in delivering the most comprehensive and educational resource to the cardiothoracic community”.

The perfect, charitable present for those who are difficult to buy for

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What do you give someone that doesn’t actually need anything?

What’s a Secret Santa present that will outdo all of your colleagues? These are now the dilemmas of Christmases past.

The Baird Institute, who specialises in applied heart and lung surgical research, has come up with the perfect solution.

It’s a gift voucher for ‘an unknown person’s heartbeat’.

It’s not your typical present, it sounds like a surrealist artwork, but there really aren’t words for how awesome this gift actually is.

(In case you’re wondering, no, it’s not literal; you won’t get a heart in a jar or any such thing.)

It’s giving made simple. You buy a Baird Institute Gift Voucher by donating the amount of your choice and writing “Gift Voucher” in the comments section. They post or email you the voucher. You hand it to your well-loved friend or colleague as their Christmas gift. The voucher explains what a difference your gift to them has made.

Your money helps improve the outcomes for patients facing heart or lung surgery.

You feel good that you may have saved a life and that it is not money wasted. The recipient feels good about it too (you’ve given them ‘someone’s heartbeat’ – how nice). You both have a great Christmas.

Heart disease is the number one killer in Australia. We lose roughly 48 people per day to the disease. That means on Christmas day it’s possible that 48 families and their extended communities may be impacted; not to mention the statistics for lung cancer.

The Baird Institute, named in honour of Professor Douglas Baird, is the only research group in Australia to focus entirely on clinical and surgical heart and lung conditions. They receive no government funding and rely solely on donations.

Here’s hoping you never have to “cash one in”.

See the difference you can make

Watch Rebecca's Story

Have a wonderful Christmas or holiday season!

The Baird Institute
Bairdinstitute.org.au

P.S As a long established and reputable charitable not for profit organisation, The Baird Institute carries an Australian Tax Office approved DGR1 status, which means all donations in excess of $2 AUD can be claimed when submitting your annual personal or business taxation assessment.

For interviews and more information contact: 

The Baird Institute CEO
Catherine Rush on 0417 068 523
[email protected]

https://www.facebook.com/bairdinstitute

High Tea

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On Thursday December 2019, a High Tea was held to thank all supporters of The Baird Institute for their generosity and to provide an update on the work of The Institute.  We all gathered at The Strathfield Event Centre for a delicious High Tea overlooking the golf course on a rather hot and hazy afternoon.  We were entertained with some wonderful uplifting songs from The Sydney Street Choir. 

Professor Bannon and Dr Woldendorp along with many of the Baird Institute supporters joined in the singing (with a bit of dancing taking place too!).  The patron of The Baird Institute, The Hon. Michael Kirby spoke of his support for The Baird Institute over many years and entertained us with his stories of when he had open heart surgery performed by Prof Bannon many years ago. We had updates from two of our educational scholarship recipients, Dr Charis Tan and Dr Kei Woldendorp and an update from Vantari VR who have developed some virtual reality software for use in aortic surgery and received some seed funding from The Baird Institute in the start-up phase.

Finally, Professor Bannon provided the group with an update on the research and training work of The Institute before we enjoyed many delicious sandwiches, scones and cakes along with a cup of tea all served on beautiful Wedgewood crockery.

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Inaugural “Take a Deep Breath” Support Group Meeting

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Take A Deep Breath’s first meeting was held on Saturday 23 November at Kingsgrove RSL with nurses, Clare Brown and Andrea Scholes facilitating the group.

A physiotherapist from RPA, Associate Professor Lissa Spencer, presented to the Take a Deep Breath group on the importance of exercise pre and post-surgery.  Her pulmonary rehab classes at RPAH had been well attended by many of the attendees at the meeting.

Our support groups focus on the power of bringing people with heart and lung disease together, to share their experiences and by so doing, to support each other pre and post-surgery.

If you would like to join “Take A Deep Breath” you can do so by going to the group Facebook page at the link below – www.facebook.com/groups/takeadeepbreathnsw/. You can also register your interest in our group meetings on our website here or call us on (02) 9550 2350.

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Professor Douglas Baird AM

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November 16, 2019 marks the 24th anniversary of the death of cardiothoracic surgeon and researcher Professor Douglas Baird AM. He would have been 79 years old.

Professor Baird was dedicated not just to improving patients’ survival rates and lives post-surgery; but to providing much needed support for other surgeons and education for students. His work has benefited countless families and individuals who, due to his efforts, have lived to tell the tale.

Professor Baird believed firmly that surgical outcomes need to be continually measured and improved. He was instrumental in creating the first national cardiac surgical database, with the National Heart Foundation. This database allows lessons from past surgeries to be implemented into current and future technologies. Though this may seem logical, it was previously unheard of at the time.

Professor Baird also pioneered the, formerly rare, combination of research and surgery; bridging the gap between academic innovation and applied cardiothoracic surgical techniques. 

Many of Professor Baird’s encounters with patients in the operating room went on to become lifelong friendships. 

In Baird’s obituary, the Hon Michael Kirby (who is now The Baird Institute patron) said:

“I will never forget how, in the middle of the long operation [on Kirby’s mother], he came out to reassure my father and me that all was going well. He was a gentle surgeon. He never lost interest in his patients. He understood their anxieties and the fears of their families. What a model he was for the best of medical practice that our country can produce…”

The Baird Institute for Applied Heart and Lung Surgical Research was started in Douglas Baird’s honour by his protege and friend Professor Paul Bannon; and his team in the Department of Cardiothoracic Surgery at Royal Prince Alfred Hospital.

“Those of us who worked with him on a daily basis knew we were in the presence of greatness, yet he made us feel that our ideas were worth listening to,” said Professor Bannon.

“We used to call him the chairman of everything,” he laughs.

“He seemed to recognise people’s skill sets and he had this overwhelming sense of responsibility for every person who came through the hospital doors.”

Professor Baird died at just 55 of Cholangiocarcinoma, a cancer of the bile ducts. 

Now, on the anniversary of his death, in order to honour and continue his life’s work; the Baird Institute is launching it’s Workplace Giving Program and Christmas Appeal. It is vital work.

Heart Disease is the number one cause of death among Australians; it kills roughly 48 people per day. The lung cancer statistics are not much more cheerful.

The Baird Institute continues Professor Douglas Baird’s life-saving work and research, driving medical breakthroughs in heart and lung surgery. 

The Baird Institute does not receive any government funding and relies solely on the generosity of the public and those who have benefited from its work. 

We would be more than grateful for any assistance or publicity for the Christmas Appeal and Workplace Giving Program.

Because every heartbeat matters, every breath counts and every dollar helps. 

Donate to the Baird Institute

Minimally Invasive Robotic Assisted Thoracoscopic Surgery

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Minimally invasive robotic assisted thoracoscopic surgery has evolved as a safe and efficacious procedure for patients with lung and pleural diseases in the United States and Europe. Through small incisions, surgeons are able to control a variety of instruments to excise lung and mediastinal cancers with three-dimensional magnified vision, seven degrees of freedom of movement and increased precision with reduced tremor.

Associate Professor Christopher Cao has led a team of leading international thoracic surgeons and medical lung cancer specialists to establish the largest international database to date to study the safety of robotic surgery for patients with lung cancer. These studies were conducted in “Memorial Sloan Kettering Cancer Center” in the United States, the largest cancer institution in the world. In addition, the studies were published in three top international journals in 2019. With support from The Baird Institute, we are analysing our own surgical results from Royal Prince Alfred Hospital to improve the clinical outcomes of patients who undergo robotic cardiothoracic surgery. Our aim is to deliver cutting edge technology to minimise risks to patients.

Launch of The Baird Institute Workplace Giving Program

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The Baird Institute has launched its Workplace Giving Program where employees can make small regular donations out of their pay to charities, through their employer’s payroll system. Workplace giving has been adopted by many companies in Australia who want to work together with their staff to create the greatest collective impact possible for charities. Workplace Giving is appealing for charities themselves as it is a low-cost revenue stream which requires minimal administration.

If you are an employer or an employee and would like to find out more about supporting The Baird Institute in this way,  please visit the Workplace Giving info page or contact our CEO, Catherine on 02 9550 2350 or [email protected]

Learn more about Workplace Giving:

Download Brochure

 

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Royal Prince Alfred Hospital
Cardiothoracic Department, Level 7,
50 Missenden Road, Camperdown, NSW, 2050

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  • Fundraise in memory of someone special to you.

Challenge Yourself

  • Run a marathon
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  • Walk 10km each day for a month
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