Cardiothoracic surgical registrar, a Master of Philosophy candidate at University of Sydney and the recipient of a Baird Institute Scholarship
What is your research topic?
My Master of Philosophy research topic is titled: “Optimising Medical and Surgical Treatments of Tricuspid Regurgitation”. The Tricuspid valve is one of 4 heart valves that helps with blood flow. Tricuspid regurgitation (TR) unfortunately is a common disease/manifestation of the tricuspid valve, caused by various factors (Primary or Secondary) and affects 65-85% of the population.
What is the aim of your research?
The main aim of my research is to understand the impact of current management strategies for Tricuspid regurgitation. Therefore, the first study is to look at patients who have been referred late for TR surgery where they’ve been suffering with right heart failure prior to surgery and understanding their outcomes vs those who have not had right heart failure before surgery. The second paper then investigates patients who have Tricuspid regurgitation due to atrial fibrillation (AF; a type of irregular heart rhythm) and outcomes after these patients have TR surgery as AF is the newest and currently under-studied cause of TR. Lastly a systematic review will be performed to understand the various outcomes of TVR for atrial fibrillation induced TR. Ultimately these studies will help us to optimise the timing of surgical treatment strategies for patients with Tricuspid regurgitation before it is too late.
What is the potential impact of your research?
Unfortunately, the Tricuspid valve has been the most neglected valve to treat until recently where TR has been recognized to be associated with deleterious outcomes. But even despite the acknowledgement of its significance, TR remains undertreated— where patients are rarely referred for surgery or often referred late for surgical intervention, and most end up never making it to surgery in time. Current European and American guidelines describe vague treatment strategies and therefore current medical and surgical strategies for Tricuspid regurgitation (TR) remain understandably controversial due to the limited data available.
Recent studies have also shown that isolated TR is independently associated with high mortality, recommending more attention to diagnosis, grading and optimum treatment strategy. However, these guidelines do not address the fact that these patients are usually at an extreme end of their tricuspid valve disease before being referred for surgery. There is a possibility that their longevity could be improved if surgery was offered earlier. Therefore, the grand plan for my research is to provide cardiologists and cardiothoracic surgeons a better understanding of the natural history of Tricuspid regurgitation and to recommend an optimum time for surgery… before they reach a stage where it’s too late and palliation ensues.
How has your scholarship from The Baird Institute helped you?
It has been a true honour to have had the support of The Baird Institute by means of a scholarship throughout my Master of Philosophy candidature. Not only have I managed to present at local and international conferences but also have managed to gain access to statistical software and undergo training courses to use them. Being around masters in this field by way of Professor Paul Bannon, has certainly opened doors to meet other experts in the field and broadened my vision for this project. Additionally, the scholarship has also allowed me to spread the word on this under-recognised area of cardiac surgery in hopes of raising more interests in research for future students and researchers at Uni presentations and conferences that I would not otherwise have had the opportunity to attend.
Once again, I cannot thank The Baird Institute enough for this huge opportunity to learn and develop as a budding researcher. I look forward to sharing the end results once its completed.