Paterson HS, Bannon PG, Taggart DP
J. Thorac. Cardiovasc. Surg. 2017 Jun;
PMID: 28651939
Enhancing surgical research at the hospital level: a new model
McBride KE, Solomon MJ, Bannon PG, Young JM
ANZ J Surg 2017 Jun;87(6):431-432
PMID: 28585756
Abstract
ATACAS clinical trial named winner of the 2017 ACTA Trial of the Year
The people who make ground breaking clinical trials happen have been honoured. These are the people who save and improve lives across Australia and around the world by funding, designing, conducting or participating in clinical trials.
As a continuous and dedicated supporter of all cardiothoracic and vascular surgery clinical trials conducted with patients undergoing heart and lung surgery at RPAH, it is our great pleasure at The Baird Institute to report that the ATACAS trial is the winner of the 2017 ACTA Clinical Trial of the Year Award at the recent Clinical Trials 2017 National Tribute and Awards Ceremony. The ceremony recognised the significant advancements and improvements made to the health of all Australians through clinical trials.
Transcatheter Mitral Valve Replacement With a Novel Dual Stent Bioprosthesis
Moore BM, Ng HKB, Naoum C, Simmons L, Cartwright BL, Wilson MK, Ng MKC
Circ Cardiovasc Interv 2017 Jun;10(6)
PMID: 28566291
Abstract
Creative Generosity
Carol & Gale Radford find a creative way to ‘give back’ to The Baird Institute.
In 2009, Carol Radford underwent a successful operation at Strathfield Private Hospital to repair a mitral valve. Her surgeon was Professor Michael Wilson from the Baird Institute.
From the time of her operation, Carol decided she wanted to ‘give back’ to The Baird Institute to help fund further cardiothoracic research.
Since then, she has been making gifts to sell at a variety of pop-up stores held at community fairs all over Sydney, including the annual Royal Prince Alfred Hospital Christmas Stall each November.
Over the past 7 years, Carol (ably assisted by her husband Gale) has raised close to $8000.
Carol works for months prior to the various events, ensuring that her stall is well stocked on the day. She makes a variety of items that clearly appeal to the community, but particularly loves making Christmas gifts. Gale is Carol’s “fetcher and carrier” and so pivotal in enabling Carol to continue operating her wonderful stalls.
Pictured: Carol & Gale at the Burwood Fair
Thank you to both Carol and Gale for all they do to help The Baird Institute continue our life saving work.
Neural network imaging to characterize brain injury in cardiac procedures: the emerging utility of connectomics
Indja B, Fanning JP, Maller JJ, Fraser JF, Bannon PG, Vallely M, Grieve SM
Br J Anaesth 2017 May;118(5):680-688
PMID: 28510745
Abstract
Cognitive dysfunction is a poorly understood but potentially devastating complication of cardiac surgery. Clinically meaningful assessment of cognitive changes after surgery is problematic because of the absence of a means to obtain reproducible, objective, and quantitative measures of the neural disturbances that cause altered brain function. By using both structural and functional connectivity magnetic resonance imaging data to construct a map of the inter-regional connections within the brain, connectomics has the potential to increase the specificity and sensitivity of perioperative neurological assessment, permitting rational individualized assessment and improvement of surgical techniques.
Acute Structural Failure of the Trifecta Aortic Valve Bioprosthesis
Zhu MZL, Newman MA, Joshi P, Passage J
Heart Lung Circ 2017 Nov;26(11):e82-e85
PMID: 28506647
Abstract
Advancements in bioprosthetic valve technology have greatly enhanced the haemodynamic performance and long-term durability of tissue valves. These features, along with the key advantage of avoiding lifelong anticoagulation, have made bioprosthetic valves increasingly attractive for clinicians and patients alike. The St Jude Trifecta valve is a novel, bovine pericardial bioprosthesis with promising early data for performance and safety. However, no prosthetic valve is perfect and prosthesis failure can occur with even the most reliable and well-designed devices. We report a case of early and acute structural deterioration (stent-post leaflet rupture) of the Trifecta valve, explanted after 33 months, in a 76-year-old male.
Robotically Assisted Minimally Invasive Off-pump Coronary Artery Bypass Surgery in a Patient With Permanent Tracheostomy
Ramponi F, Flynn CD, Wilson MK
Heart Lung Circ 2017 Apr;
PMID: 28456599
Abstract
BACKGROUND: Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic internal mammary harvest and hybrid revascularization.
HOW TO DO IT: We report a case of robotic assisted (daVinci(®)Xi™ Surgical System) total arterial off-pump revascularization in a patient with previous laryngectomy and permanent tracheostomy. The main advantage of this approach was to minimize the risk of post-operative sternal complication and mediastinatis, whilst still providing the prognostic benefit of total arterial grafting and the neurological advantage of the aorta no-touch technique.
Costly robotic surgery “more acccesible” after opening of new Sydney training facility
Professor Paul Bannon, Chairman of The Baird Institute, talks to the ABC News about the opening of the country’s first robotic surgery training facility called the “RPA Surgical and Robotic Training Institute” at Royal Prince Alfred Hospital.
The facility will have the ability to train up to 400 surgeons each year in the use of the robot and as a result, more patients will have access to these less invasive procedures on the operating table. The robot used to train the surgeons at the Institute cost around $4 million.
Robotic surgery allows us to perform complex procedures at a distance, with great precision and great control”, says Professor Bannon. With this technology, surgeons make less invasive incisions which result in better outcomes and improved recovery times for the patient. A quicker recovery means less time in hospital which in turn means a lower cost.
The robots have been used for several years in Australia, largely in private hospitals. However, Australian surgeons have had to travel overseas to develop their skills and this has been difficult due to the costs involved and a surgeon’s busy schedule.
Now, with the opening of the new training institute, the surgeons will be able to advance their knowledge in Australia, without the necessity to travel overseas. This in turn will allow more public patients access to the less invasive procedures that robot allows.
Robotic surgery allows us to perform complex procedures at a distance, with great precision and great control.
We want to know how to teach robotic surgery and how to teach it better and we want to know exactly what the benefits to the patients are.
A robotics surgery symposium will be held in late June where doctors will discuss having a national register for surgeons who provide robotic treatment. The meeting will also address discretionary surgeon fees for such procedures.
View the original ABC News story here
KEY POINTS
- For more than a decade, robotic machines have largely been used in private hospitals for procedures like robotic prostatectomy to treat prostate cancer and robotic mitral valve surgery for heart failure patients.
- Nepean Hospital has been using robots for four years in the public system, however surgeons still had to travel to the United States for some of their training.
- A 2016 Australian study published in prestigious journal The Lancet questioned the value of using expensive robotic technology to treat prostate cancer patients.
- The Surgical and Robotics Training Institute will also collect patient outcome data and present its findings to state and federal governments.
Plasma mediated protein immobilisation enhances the vascular compatibility of polyurethane with tissue matched mechanical properties
Kondyurina I, Wise SG, Ngo AKY, Filipe EC, Kondyurin A, Weiss AS, Bao S, Bilek MMM
Biomed Mater 2017 Jul;12(4):045002
PMID: 28435148
Abstract
Polyurethanes are a diverse class of polymers, with independently tunable mechanical and biodegradation properties making them a versatile platform material for biomedical implants. Previous iterations have failed to adequately embody appropriate mechanical and biological properties, particularly for vascular medicine where strength, compliance and multifaceted biocompatibility are required. We have synthesized a new polyurethane formulation with finely tuned mechanical properties, combining high strength and extensibility with a low Young’s modulus. Additional cross-linking during synthesis enhanced stability and limits leaching. Under cyclic testing, hysteresis was minimal following completion of the initial cycles, indicating the robustness of the material. Building on this platform, we used plasma immersion ion implantation to activate the polymer surface and functionalized it with recombinant human tropoelastin. With tropoelastin covalently bound to the surface, human coronary endothelial cells showed improved attachment and proliferation. In the presence of heparinized whole blood, tropoelastin-coated polyurethane showed very low thrombogenicity in both static and flow conditions. Using this formulation, we synthesized robust, elastic prototype conduits which easily retained multiple sutures and were successfully implanted in a pilot rat aortic interposition model. We have thus created an elastic, strong biomaterial platform, functionalized with an important regulator of vascular biology, with the potential for further evaluation as a new synthetic graft material.
