TWENTY-FIVE years ago, at a time when Teesside had some of the worst health statistics in the country, cardiothoracic surgery began at a new centre based at South Cleveland Hospital.

Since then the team of surgeons, at what is now The James Cook University Hospital, have carried out 33,000 operations, with patients now benefiting from world-renowned surgery, including cutting edge robotic procedures and minimally invasive techniques.

The changes over the last 25 years have been significant.

Not least that there has been a 74 per cent reduction in coronary heart disease.

But with that reduction comes the challenge for doctors of treating patients who are much older and who have more complex conditions.

Consultant cardiothoracic surgeon, Simon Kendall says: “Cardiothoracic surgery has significant risks and involves complex operations, with complex anaesthesia and post-operative care.

“When the unit started out 25 years ago, the local population had one of the highest incidences of coronary heart disease in the country – and this was one of the reasons that the unit was set up.

“Since then, advances in surgery and the care of patients means that people are living longer with much more complex conditions and many of our patients are much older – which is great news for our patients, but means that operations have become more challenging.

“The advances mean that we’ve reduced the length of time our patients need to spend in hospital recovering – down from typically seven days to four days.”

The team has extensive experience in minimally invasive (keyhole) surgery for aortic valve replacement – the second most common type of heart operation – and have been at the forefront of leading research projects such as the MAVRIC trial, which enabled surgeons to compare keyhole surgery to conventional surgery, while also hosting live surgical masterclasses which allow students and fellow medical professionals to ask questions and observe live operating via a video link to theatre.

Enoch Akowuah is the chief investigator for the UK Mini Mitral Trial – which is the only one of its type worldwide.

It is the first randomised controlled trial to help develop techniques and practices for minimally invasive mitral valve surgery.

The surgeons have also helped over the years with many world firsts, including making international headlines in 2016 for being the first outside of clinical trials to implant a WiSE wireless pacemaker the size of a grain of rice.

Just one example of how closely the cardiothoracic surgeons work with related specialties, in this case cardiology.

Innovations

MORE recently the team has introduced a new treatment to improve lung function without the need for open surgery. The new procedure involves inserting a tiny artificial valve – called a Pulmonx valve – into the lung.

This one-way valve prevents airflow into the diseased part of the lung, allowing healthier regions to expand and function more efficiently.

Pat Maloney, from Normanby, was one of the first to benefit from the new treatment. Pat had four Pulmonx valves inserted into her lung in a 20-minute procedure.

The Northern Echo:

Before this, Pat’s advanced emphysema had left her very breathless and reliant on home oxygen. But the retired library assistant is now off the home oxygen and says she is feeling “marvellous”.

“Before the procedure I was on oxygen, I could not shower or dress – trivial things I could not do,” she says. “Now I can potter in the garden or go shopping.”

Traditionally emphysema is treated with an operation to remove part of the damaged lung but in Pat’s case this was thought to be too high risk.

Cardiothoracic surgeon Joel Dunning says: “There are around 3,000 people in the region on home oxygen; only half have seen a specialist. But this new treatment improves lung function, exercise capacity and quality of life.”

Robotic surgery came to Teesside in 2014. James Cook now has the longest continuous robotic thoracic surgery programme in the country and quickly became the first in the UK to use it to carry out a diaphragm plication – an operation to repair a paralysed diaphragm, a robotic thymectomy and in another UK first the hospital’s Da Vinci robot was also used for the removal of a tumour from the main airway of a lung.

The robot revolutionised surgical treatment by making it possible for surgeons to perform minimally-invasive surgery with greater precision and control than ever before. Its tiny instruments, controlled remotely by the surgeon sitting at a console, have a greater range of movement than the human hand.

Charity fundraising

A YEAR after the heart unit opened, The South Cleveland Heart Fund was established. The charity has since raised £2.5m through fundraisers, donations and legacies from patients and families.

The heart team has also been doing some fundraising of its own recently with a team of volunteers currently in Ghana to perform surgery in Komfo Anokye Teaching Hospital in Kumasi. Cardiothoracic surgeon Mr Enoch Akowuah, who was born in Ghana, says: “The hospital has just appointed a cardiac surgeon but they have no kit and there are lots of patients who need operations. We hope to complete at least five open heart procedures and implant ten pacemakers while we are out there.

“Being able to offer this opportunity to young adults who would otherwise not have access to life-saving heart surgery is a real privilege for all of us.

“I’ve been blown away by the enthusiasm of the whole unit to help pull this mission together. Everyone wants to help or be involved in some way, not only those who are actually going on the trip, but by raising funds and providing support for the team.”

nDonations can be sent to South Cleveland Heart Fund (clearly marked for Ghana mission) or visit https://www.justgiving.com/crowdfunding/heartsurgerymissiontoghana