THINK AORTA campaign update

Heart Research UK is funding the ‘THINK AORTA’ campaign, which aims to highlight early diagnosis of aortic dissection.

Aortic dissection is a rare but life-threatening condition where there is a tear in the inner wall of the aorta, the main artery in the body and carries blood from the heart to all organs.
The campaign was devised by Aortic Dissection Awareness UK, in collaboration with the Society for Cardiothoracic Surgery (SCTS) and the Royal College of Emergency Medicine (RCEM).

THINK AORTA Poster
The campaign includes the design, printing and distribution of a ‘THINK AORTA’ poster to all 229 emergency departments in the UK and Ireland to help educate patients and medical professionals.

THINK AORTA podcast and film
Also, a podcast and educational film has been produced for the RCEM online learning. In the podcast, patients and health professionals share their experiences of aortic dissection.
The educational film follows the golden patient pathway of a patient suffering from an acute aortic dissection – from the 999 call, to paramedics, to emergency department triage, to differential diagnosis, to radiology CT scanning, to confirmed diagnosis, to transfer for surgery.

Further information 
You can read more about the THINK AORTA campaign, listen to the podcast, watch the film and download the poster from www.thinkaorta.net/

Update on the campaign
Our ‘THINK AORTA’ poster has already been sent to emergency departments in the UK and Ireland, and the THINK AORTA US team has now distributed posters to all 6,300 emergency departments in the USA.

The Healthcare Safety Investigation Branch has published their investigation report into delayed recognition of aortic dissection. You can read more at https://www.hsib.org.uk/news/earlier-recognition-aortic-dissection-needed-prevent-deaths/

Celebrating 45 years of successful heart transplant surgery this Heart Month

By Olivia Schofield

1979 marked a year of significant change for heart transplant surgery in the UK nearly 45 years ago. One which revolutionised heart transplant surgery to become what we know today. The beginning of heart transplant surgery. South Africa had the first successful attempt of heart transplant surgery globally, and it was South African surgeon, Christiaan Barnard’s first successful heart transplant in 1967 which acted as a catalyst for more attempts at heart transplant surgery across the world.

The first attempts at heart transplantation in the UK were performed by the surgeon, Mr Donald Ross in 1968. Sadly, whilst the transplants themselves were completed; the first three patients died within weeks due to major issues of organ rejection.

Despite a moratorium in 1973 which had acted as an effective ban on these surgeries in the UK. It was accomplished cardiac surgeon, Sir Terence English, who could not be dissuaded in his pursuit to continue heart transplant surgery in the UK.

Facing challenges

Even though there were advances around heart transplant surgery, there was subsequent media and political negativity. Sir Terence English, the pioneering surgeon at Royal Papworth Hospital, approached the local Cambridge Authority, which provided funding for heart transplantation to occur within Royal Papworth Hospital’s facilities.

Unfortunately, Sir Terence’s first attempt at heart transplant surgery in January 1979 was unsuccessful as the patient had only survived a few weeks after the heart transplant.

Sir Terence carried out his second surgery in August 1979 at Royal Papworth Hospital on Keith Castle, a 52-year-old who went on to survive over five years post-transplant. This went on to become the first successful heart transplant in UK history.

The successful heart transplant on Keith Castle proved to be a significant breakthrough that Sir Terence and the UK needed. As Sir Terence had funding for only two attempts, this was his last chance. If the transplant had failed, it would have been unlikely that he would have received further funding. However, the success of the second attempt enabled Sir Terence to secure funding from Heart Research UK.

Formerly known as the National Heart Research Fund, Heart Research UK funded the following six heart transplant surgeries in the UK, at what was then called Papworth Hospital.

After Sir Terence had performed two consecutive successful transplants, it provided sufficient evidence to the central regulatory and funding bodies to allow a full-scale transplant programme at Royal Papworth Hospital in Cambridge. This in turn led to the inclusion of heart transplantation within the NHS.Heart transplant surgery today. Since the first UK heart transplant in 1968, there have been approximately 9,000 heart transplants in the UK.

Heart Research UK has also funded a Translational Research Project (TRP) Grant towards research at Royal Papworth Hospital NHS Foundation Trust, exploring the effectiveness of fluids for the preservation of donor hearts. This will continue to support the development of pioneering heart transplant surgery.

Heart Research UK and Royal Papworth Hospital also hosts an annual surgical masterclass on heart and lung transplantation led by Marius Berman, Cardiothoracic and Transplant Surgeon at Royal Papworth Hospital.

45 years is a significant milestone and it’s because of you that we can continue to fund lifesaving research into heart transplant surgery. The next 45 years of heart transplant surgery are decided by people like you.

Black History Month: Notable black figures who pioneered cardiology

October marks the start of Black History Month and at Heart Research UK we wanted to honour notable black cardiologists throughout history and the extraordinary work they have contributed to their field, paving the way for the modern treatments and surgeries we have today.

Early heart surgery and the venture into the unknown – Daniel Hale Williams

Today, heart surgery is commonplace however, this was not always the case. Cardiologist Daniel Hale Williams was one of the first doctors to perform open-heart surgery in the United States. In the late 19th century, many surgeons believed that surgery was impractical and unethical. However, the former shoemaker’s apprentice would not take no for an answer. Instead, he performed the first surgery in 1893 on 24-year-old James Cornish who had stuffed a stab wound, damaging the protective sac surrounding his heart, called pericardium. Dr Williams’ operation was successful and William’s contributions in medicine went beyond the operating room.

The physician helped found the Provident Hospital and Training School for Nurses, reportedly the first U.S. hospital with both Black and White staff members. He also established the National Medical Association, a professional organisation for African Americans in medicine.

Bravely venturing into the unknown, Dr Williams’ incredible contributions helped pave the way to future successes in heart surgery.

Treating critically ill babies and combating racism – Vivien Theodore Thomas

After losing most of his savings and dropping out of college during the Great Depression, former carpenter Vivien Theodore Thomas helped to pioneer surgery to cure the congenital heart condition called tetralogy of Fallot. The condition involves four abnormalities in the heart’s structure including a narrowed pulmonary valve, thickened muscle of the right ventricle, one of the lower heart chambers and an overriding aorta (the largest artery in the body).

The cardiologist trained as a surgical assistant in the 1930’s and in 1944 he helped to develop the initiative “blue baby surgery”, to correct the congenital heart condition, along with surgeon Dr. Alfred Blalock and paediatric cardiologist Dr. Helen Taussig at The Johns Hopkins Hospital. After realising that the key was increasing blood flow to the lungs and around the body, and by repairing some of the abnormalities, Blalock and Thomas performed their first surgery on a child called Eileen Saxon, who was an 18-month-old baby born with tetralogy of Fallout. Thomas was unable to perform the surgery because he did not have a university degree instead, he had to coach Blalock through the painstaking surgery.

Unfortunately, Eileen’s surgery only prolonged her life for a few months; however, the pair repeated the surgical procedure on two more children, which were both successful. Thomas’ work marked the start of essential cutting-edge surgery to save the lives of children born with heart conditions. However, due to racism and prejudice towards his lack of university education Viven Thomas’ crucial role was not recognised as the procedure was initially called the Blalock-Taussig shunt with no mention of Thomas in the papers.

Leading female cardiologists – Myra Adele Logan, Elizabeth Odilile Ofili and Dr. Jennifer Mieres.

During the early 1940’s Dr. Myra Adele Logan became the first woman to perform open-heart surgery which was reportedly the ninth time the procedure had been performed worldwide.

Logan’s research extended beyond heart surgery as she also studied antibiotics and breast cancer. Notably, her contributions included the development of more accurate tests to detect the density differences in breast tissue. Her work extended beyond the medical field as a surgeon, and at the Harlem Hospital in New York, she was also a founding partner of the first physicians group practices in the United States.

Elizabeth Odilile Ofili, also made a vital impact in the field of cardiology with her leadership of the “Landmark African American Heart Trial” (AHEFT). This trial changed the guideline on how heart failure is treated among African Americans today. Ofili is recognised globally for her dedication to cardiovascular disparities in women’s health.

Finally, another leading female figure who paved the way, Dr. Jennifer Mieres, is one of the leading cardiovascular disease experts, and her dedication to patient advocacy and mentorship was recognised by the “ACC’s 2014 Women in Cardiology mentoring award.”

A pioneer and advocate – Charles R. Drew

Bright student Charles R. Drew did not know what to do for his career until two experiences got him interested in medicine. An injury on the football field and his sister’s tuberculosis helped him to discover a passion for medicine and an interest in how the body works.

Whilst studying at McGill University Faculty of Medicine, Drew became interested in transfusion medicine during his surgical residency where he worked with bacteriologist John Beattie. This led Drew to conduct research into transfusion medicine where he found if you separate blood from plasma, it lasted longer making it possible for blood to be stored. This meant that blood could be preserved and shipped overseas where it could even be taken to a battlefield. In 1940, Drew became a lead on the special medical effort called Blood for Britain during the Second World War.

Drew also became assistant director of a new national blood bank system for the American Red Cross collecting 10,000 pints of blood for the war effort. However, the military stated that blood taken from African American donors should not be given to white people. Drew knew this was scientifically and morally wrong and he spoke out against the racism, subsequently resigning from his job.

He then went on to become Chief of Surgery at Freedmen’s Hospital where he spent the next nine years mentoring students and advocating education and inclusion for African Americans in medicine.