Professor of Cardiac Surgery & Transplantation. Medical Examiner. Chairman EBCTS. Board Member ECTTA., Academy of Master Surgeon Educators, Private Pilot
After 34 years of use (admittedly less in recent years!) my trusty Littmann Cardiology II stethoscope has broken. Bought before I started as a house officer it almost made it through to the end but not quite.
Congratulations to our Fellow, Vishal on his second complete heart transplant. A real pleasure to assist him. The recipient is great and profound thanks go to the donor and their family for their extraordinary gift of life to another. Vishal heads now to India with these skills.
Another picture of our latest heart transplant simulator prototype for surgeons in training. You can cut it, suture it, repair it with silicone gel and use it over and over until you have the operative technique perfected before going anywhere near a patient.
DCD heart transplantation has been transformative. One of the great things for the UK is how teams from other Centres combine to get patients the transplants they need. Here is a joint Papworth/Harefield team delivering an organ to us in Newcastle this weekend. Amazing teamwork
Great to be back in theatre again after a long and challenging recovery from COVID19. Thoughts are with those still in that daunting and formidable fight and those families who have lost loved ones to this awful disease. I know I have been very very lucky.
Work on our heart transplant simulator for trainees and surgeons wishing to learn and practice this operation is progressing well. The use of modern materials to simulate human organs for teaching surgery is advancing at a rapid pace.
@NewcastleHosps
Example of our research project using machine learning/object detection to automatically track surgeons hands and instruments across a cardiac surgical operating field to learn more about ergonomics and how it differs between surgeons in different situations
@NewcastleHosps
Just out of theatre after a technically demanding heart transplant. Great on call team to work with who stayed on top form through 7 hours of surgery. Our theatre porter was superb with many trips to and from blood bank. Everyone plays their part in providing excellent care.
Heart transplant simulator for teaching young surgeons the surgical technique without any impact on patients is coming along nicely in our latest prototype. Generated via 3D printing from the CT scan of a real waiting list case then modelled in silicone. State of the art training
Practicing heart transplant technique with our simulator modelled from real patients CT scans and reproduced in silicon it replicates human tissues and ideal for the early training of Transplant Fellows with no risk to patients. Can be set up anywhere and repaired and reused.
Amazing news from Hyderabad as our former Fellow, Vishal (who we trained in cardiac transplantation) successfully undertook the first heart transplant in his medical college. Congratulations on this superb achievement from a very proud team of friends and colleagues in Newcastle!
Wonderful news from India from our former Transplant Fellow Vishal who has successfully undertaken a heart transplant in this young girl after our training and guidance in Newcastle.
A pleasure to take our Fellow through his first heart transplant from the very start to the very end. The recipient is doing fantastically well. He will soon be leaving to take these skills and his experiences with us back to his hospital in India to help those in heart failure.
Fantastic effort by all in Cardiothoracic theatres in the last 2 days with 3 heart and 1 double lung transplants performed out of hours. Great teamwork from all to make this happen for the many patients in our waiting list. Lots of tired people about today but worth it.
#nuth
5 Consultant Surgeons in the Dept at 8pm last night (only one of whom was actually on call) going through complex endocarditis referrals together and reviewing echos to get surgical management plans in place. Great working alongside my colleagues Espeed, Ramesh, Asif and Simon
It’s been a very busy couple of days transplanting hearts and lungs in Newcastle. Fantastic team effort as always but greatest thanks are always to the donors and their families whose generosity and wish to help others is always humbling
#ECTTA
Our heart and lung transplant simulator is coming along nicely to help the next generation train to perform these operations safely and refine skills alongside an experienced surgical trainer. Realistic & reusable - thank you Newcastle Hospitals Charity and FHLTA for your support
8 hour long operations like today need incredible stamina and dedication from the whole team each looking after their area of responsibility but working in unison. Seldom fully appreciated. What a great group of colleagues in theatre today and a great patient outcome at NUTH.
Check out this newly published book! Edited and written by many Newcastle based colleagues. A pleasure to contribute to the Lung Transplantation chapter with Maria Mckenna who has put palliative care in cardiothoracic transplantation on the map.
#nuth
The team behind our recent successful combined lung and liver transplant. Our patient has done wonderfully well and will be home very soon. Lots of planning, teamwork and multidisciplinary co-operation and expertise made this possible.
@NewcastleHosps
XVivo Heartbox training days complete and Newcastle is almost ready to start using this exciting technology to better preserve hearts for transplantation in our unit. We are 1 of 15 hospitals in 8 countries evaluating this device used for the recent pig to human heart transplant
03.30AM. In the hospital to start the second transplant we have done today - a heart this time. Nice to watch the Olympics while we are getting ready though.
We have successfully performed another quadruple valve replacement, an exceptionally rare operation. This was the worlds first use of 4 Inspiris Resilia/Mitris prostheses and the worlds first use of the Mitris valve in the tricuspid and pulmonary positions.
@newcastlehosps
Honoured to be at the Royal College of Surgeons in Edinburgh today to receive the Dundas Medal with my colleague Maria Mckenna. Innovative teamwork at NUTH has established a superb palliative care service for patients in our heart and lung transplant program
Just about to start 3D printing our first heart model prototype from a patients CT scan to help intra-operative planning and improve patient safety in complex cardiac transplants. Being able to hold the recipients “heart” in your hands before surgery may make a difference.
Evaluating our latest prototype of our heart transplant simulator. Created from real waiting list patients CT scans, 3D modelled then replicated in silicone. Very realistic “tissue” characteristics and handling gives surgeons learning the technique great opportunity.
Fantastic team effort by all in Cardiothoracic Transplant theatre. Our most recent operation was a complex and challenging case but a very deserving recipient who has patiently waited many months for their chance. Please donate!
A privilege to be involved in a huge effort in Resus whilst on call. From start to finish it must have involved over 50 colleagues. All highly professional and calm employing advanced circulatory support. Truly the NHS at its best. Amazing teamwork.
Great teamwork this week doing a VAD explantation heart transplant, one of the most challenging operations we face these days. Comprehensive planning and preparation, attention to detail, excellent ITU care and great colleagues working together gets the best results
Newcastle is now days away from the scientific trial of the Xvivo Heartbox to better preserve hearts for transplantation compared to a conventional icebox. This was used recently at the University of Maryland for their pig to human transplant. Exciting times ahead. More to follow
In tonight to help my colleague and friend with a very challenging heart transplant. Great team to work with and my favourite operation to do. But we need many more to sign up to the donor organ register to help those patients in greatest need.
So pleased to receive funding to start a clinical ex vivo lung perfusion program with the latest generation technology to increase the number of lung transplants performed in Newcastle. Such good news for the many patients in desperate need on our waiting list.
#nuth
Something special happened. Took one of our young trainees through their first ever cardiac surgery case. They did a fantastic job - patient is doing very well indeed. In contrast my first case took so long they were going to take the theatre clock down and put up a calender.
Superb work by our cardiac surgery team late at night operating on a patient with an immediately life threatening aortic dissection. A cool professional team approach to this disease which needs greater publicity to encourage earlier diagnosis. Very pleased with the super outcome
Dramatic developments for heart xenotransplantation. The technology has advanced significantly since the implant of a baboon heart into Baby Fae in the 80’s. All will be watching anxiously and hoping for success where there were no other options.
Thank you to the ACS for my nomination to the Academy. Only the fourth UK surgeon to receive this honour but hopefully more will follow. This will drive forward our work on Cardiothoracic and Transplant surgical education and examination in the UK and Europe.
Fabulous effort from our anaesthetists caring for a critical heart failure patient and keeping them very comfortable while urgent ECMO support was instituted surgically under local anaesthetic. The wait for a donor heart begins. Professional teamwork despite heading home at 5am!
Close collaboration of cardiac and thoracic surgeons working with anaesthetic and theatre nursing colleagues can be very successful in resecting huge mediastinal tumours declined by other units. Two cases in a fortnight and many others previously. Great multidisciplinary teamwork
I always enjoy seeing my post operative cardiac surgical patients in clinic. Very grateful for the attire chosen by a wonderful man now looking forward to the future with renewed confidence and relieved of crippling symptoms. Well done NUTH!
If you want to understand cardiopulmonary bypass I recommend this recently published book. We were pleased to contribute a chapter from Newcastle but this is the most comprehensive text on extracorporeal circulation I have seen.
Fantastic teamwork in cardiac theatres this weekend on call dealing with a cardiac arrest after cath lab complications and emergency ECMO for profound cardiogenic shock. Great work but wonder what will happen next! A transplant would be nice!
On call this weekend - set up three transplants only for them all to fall through for one reason or another. Desperate for those on the waiting list, several of whom have been in many times only for their surgery not to happen. Join the donor organ register and make a difference!
Teaching surgeons from New Zealand, Hong Kong, India and Pakistan how to do heart transplants on our course today. NUTH at its best sharing our experience and knowledge in the excellent surgical simulation and training facilities we have.
Proud of NUTH Cardiothoracic Surgeons for being chosen as one of only two U.K. units to take part in an international trial of new heart transplant technology. Shows Newcastle’s standing in the discipline and research commitment. Protocol now written and can’t wait to start.
In trials comparing TAVI and surgical AVR there are substantial deviations from assigned treatment, loss of follow-up, and additional procedures together with systematic selective imbalance that may affect internal validity.
Very pleased to qualify as a Medical Examiner. Now part of a national network of specifically trained independent senior doctors who scrutinise all deaths that do not fall under the coroners jurisdiction. Fantastic for families, clinical governance and learning.
#medicalexaminer
Pleased to receive my Diploma in Medical Law and Ethics. An excellent course and thought provoking. Recommended to all interested in medicolegal case work.
EACTS Academy heart and lung transplantation course in full swing in Newcastle. Surgeons from all over Europe here to learn and train with our local and international Faculty.
@NewcastleHosps
We have secured a grant for our 3D printed lung project to improve safety and decision making in pulmonary transplantation. And got a paper accepted in ERJ. Enjoying some good news in otherwise difficult times.
Re the Archie Battersbee case this was a disappointing comment, unhelpful to many families facing withdrawal of treatment on ICUs around the UK. Patients do not suffocate. I have always seen this done with great compassion, comfort and care with respect to the end and beyond
Bailey and Loves Short Practice of Surgery has been a classic text since 1932. I used the 21st edition for my exams in general surgery. So thrilled many years later to contribute its first ever chapter on heart and lung transplantation for the 28th edition about to be published.
Reminded today thinking about the sad Archie Battersbee case that it is wrong to report that his care is to be withdrawn. He has been cared for every hour by medical/nursing staff since the day he was admitted. It is his treatment that will rightly cease. Care never ends.
Great to transplant another urgently listed patient who was in desperate need. A great operation for patients that has stood the test of time and remains the gold standard for end stage heart failure. Please donate!
My last Carlisle clinic was today after over 2 decades of looking after cardiac surgery patients in Cumbria through clinics and the local MDT meeting. I will miss my visits,the patients and my cardiology colleagues there.And the sun came out for my final trip over from Newcastle!
Proud of our great team in NUTH cardiac theatres yesterday. A long and difficult case but a World first and all done through two small incisions. Wonderful to see the trainees involved enthusiastic about writing it up and presenting it internationally
Very interesting having BBC Radio with us following the patient journey through heart surgery. Will be a fascinating program with a special twist when broadcast in the New Year.
Almost time for the Newcastle Cardiopulmonary Transplantation Course which is now part of the EACTS Academy portfolio. Very proud that after a decade of success since its inception that the course is now firmly established as an outstanding European educational opportunity.
Thank you to the FA for inviting me to talk recently on the UEFA Pro Licence Course at St Georges Park on how heart transplant teams work, function, prepare for success and deal with failure - very impressive focus on leadership and teamwork in their set up
Received my Fellowship of the American College Of Surgeons at last. Over a year of scrutiny and examination with a tough interview but well worth it. Highly recommended to surgeons internationally.
Just a heads up for the cardiac theatre team who have long suffered my Strictly super fandom for many years. An extraordinary performance which will make the deaf community rightly very proud.
I have seldom agreed with Boris Johnson but his words this evening can’t be bettered. Our Queen has been a constant presence in British life with grace, wisdom, sense of duty and admired across the world. It is a moment in history today but a lifetime of leadership and respect.
13 abstracts accepted for the SCTS meeting next year. So proud to have worked with so many of our fantastic trainees to achieve this across a range of research projects in cardiac surgery, transplantation and human factors.
Really disappointing and disrespectful of the mask wearing rules we have to follow and have in place to protect eachother during a visit to a hospital by the PM. Undermines enforcement with staff, patients and visitors.
Superb team effort from all in Cardio theatres yesterday for our first implants of the sutureless Intuity Elite aortic heart valve. Patients doing fantastically well as a result of this latest technology to reduce cross clamp and bypass times in high risk cases
#NUTH
An excellent method of conveying organs for transplantation which should be adopted by NHSBT without delay. Also I think Consultant Transplant Surgeons should accompany organs whenever possible and could selflessly offer to have the vehicle kept at home (just in case its needed)
Absolute professionalism from KLM pilots last night when birds went through the right engine at Schiphol needing a high speed rejected take off. Kudos to the Captain coming through the cabin afterwards to check everyone was OK. Leadership and training counts when things go bad.
I wish Chris Feindel all the best in his retirement. For everyone he trained in Toronto (in 2000 for me) he was a rare combination of unparalleled surgical talent, wisdom, calm and professionalism. Universally respected and irreplaceable.
I occlude the left atrial appendage in all cardiac surgical cases I operate on with AF. It’s great to see some definitive science to support this simple addition to any operation but which has a significant benefit to patients.
Minimally invasive endoscopic saphenous vein harvesting in my theatre today for coronary artery bypass grafting. One tiny incision in place of a scar along the entire length of the leg. Superb for patients.
@NewcastleHosps
Enjoyed taking one of our trainees through this case - left atrial myxoma needing a complex patch reconstruction of the left atrial roof and septum. Better out than in! Patient is doing great!
Great work by our very talented medical students to produce rapid prototyping 3D printed lungs from the CT scans of potential lung transplant recipients. An exciting project ahead to increase patient safety with better donor size matching ahead of transplant surgery
Excellent work on display from our Palliative Care team led by Maria McKenna looking at end of life care in VAD patients. Great ideas to improve patient and family experience for the future.
#ISHLT2019
#NUTH
To all my friends and colleagues on Twitter - I wish you and your families all a very merry Christmas and a Happy New Year! Lots of interesting and exciting developments with new challenges ahead for 2020 both in Newcastle and abroad. Looking forward to it!
These are interesting reflections from retired surgeons. A sub specialty analysis would be fascinating but there are some important issues here for all to consider.
A wonderful evening out for a Persian dinner with colleagues to bid farewell to Espeed who leaves us for Harefield. Sad to lose such a hard working, dedicated, honest friend and colleague but we all wish him and his family well for their future in London.
Saw this today whilst operating in the Institute of Transplantation. We need this in Cardio theatres too! Great reminder to maintain high standards for our patients.
Delighted that we were highly commended in the Excellence in Education category of the NHSBT/BTS Awards for our work developing a state of the art digital resource for patients being assessed for heart and lung transplantation yesterday.
Thank you to the FA for inviting me to talk again on the UEFA Pro Licence Course at St George’s Park on how heart transplant teams work, function, learn from others and prepare for success and deal with failure. An honour to meet the truly inspiring Sarina Wiegman.
Looking forward to welcoming surgeons from around the World to our course tomorrow. Previous years have started heart transplant programs in India and Sri Lanka so we are all very proud of the NUTH transplant program and sharing what we know.
Wonderful for our transplant team to win an award from the Society for Cardiothoracic Surgery in Great Britain and Ireland this week. This comes soon after being highly commended for excellence in education by NHSBT last month.
Thank you Joe Costin
@bbccumbria
for sharing this amazing painting of us undertaking cardiac surgery. Created by a very talented colleague in his team from a photo taken when Joe visited us to watch the very operation he had had just a few weeks earlier.
Proud to be part of this amazing team of examiners and Board members delivering the first European examinations in critical care for cardiovascular surgeons. Professionalism and commitment to the science of assessing surgeons by the whole team made this possible.
On this day in 1983, Dr. Magdi Yacoub performed the UK's first combined heart and lung transplant. It took a team of 20 doctors and nurses in north London, and the operation lasted more than 5 hours.
So proud of our cardiac team that day. Shows the benefits of emergent ECMO in extreme circumstances. ECMO established within 20 mins of our arrival. Extraordinary effort across many disciplines - NUTH at the cutting edge of emergency care
#NUTH
@JackieDanielNHS
@KatieThornalley
“One of the most significant factors in Kacper’s survival was the use of Extracorporeal Membrane Oxygenation (ECMO) – a service in this region, only available at the Freeman Hospital in Newcastle.”
The amazing story of how 13 year old Kacper survived after 25 mins under water
NEJM has this week published the full report of the recent pig to human heart xenotransplant. After 49 days it seems the graft showed no typical features of rejection and more research is required to evaluate the reasons for eventual heart failure.