For patients with coronary or valvular heart disease whose symptoms can not be controlled with medication, lifesaving surgery can be necessary.
The North West Heart Centre is one of the leading specialist surgery centres in the UK for life-saving coronary bypass surgery valve operations transplant and artificial heart surgery. The Clinical Lead for Heart Surgery at MFT is Professor Rajamiyer Venkateswaran.
The department of cardiothoracic surgery – which performs surgery involving the heart, lungs, and wider chest area – is located at MFT’s Wythenshawe Hospital. Staff working in this service provide high quality healthcare to the people of Manchester and beyond.
We are one of the five national heart and lung transplant units in the UK, as well as providing artificial heart services – ventricular assist devices (VAD) and artificial lung – Extra corporeal membrane oxygenation (ECMO) – for the Northwest of England and beyond.
Coronary artery bypass grafts
Narrowing or blockages in the coronary arteries, known as coronary artery disease, can prevent enough blood from reaching the heart muscle. This can lead to ‘angina’ – severe chest pain. During a coronary artery bypass graft, part of the great saphenous vein is taken from the leg or occasionally the arm, and often an artery is taken from the chest wall (the internal mammary artery). Our surgeon then uses these tissues to bypass blockages and create new routes for blood to flow to the heart muscle. These new routes are called coronary artery bypass grafts.
This procedure can be performed with or without a heart lung bypass machine. When a heart/lung bypass machine is used, blood is diverted away from the heart and into the machine, allowing the surgeon to work on an ’empty and dry’ heart. The heart/lung machine takes over the roles of the heart and lungs during surgery. When coronary artery surgery is performed ‘off bypass’, the heart is not stopped and the surgeon bypasses the blockages while the heart is still beating. Your decision will decide whether your operation requires the heart/lung bypass machine or not.
Coronary artery surgery is a very successful treatment for angina. It is recommended for many patients with narrowing of the coronary arteries who have persisting angina despite medical treatment. It can also be appropriate for some patients who have few symptoms but have severe narrowing in their coronary arteries.
The heart has four valves. They make sure that blood is only pumped in one direction towards the lungs and body. These valves may be damaged from birth, after rheumatic fever, from wear and tear, or following a heart attack. The valve may become narrowed, which is called stenosis, and causes a block to normal blood flow or may become leaky and allow back flow of blood (called regurgitation). In both cases the heart has to work harder and eventually surgery may be necessary.
The damaged valve can either be repaired or replaced. A replacement valve can either be mechanical – made from metal or plastic, or tissue – from an animal, usually a pig. Mechanical valves are longer lasting but patients will need to take anti-coagulant drugs those which thin the blood for the rest of your life. Tissue valves do not last indefinitely but patients are less likely to require anti-coagulant drugs. If you need a valve operation, our surgeons will discuss the most suitable valve in your case. All valve operations are performed with the heart/lung bypass machine.
Patients can reduce the risk of this happening by adopting a healthier lifestyle including giving up smoking, taking up exercise, eating a healthy diet, reducing alcohol intake, and controlling blood pressure.
Surgical results in heart surgery are scrutinised more closely than in any other field. Here at MFT, we have a long history of collecting and analysing surgical data. Some caution should be taken when looking at mortality following surgical operations, as the most important influence on the likely survival following any given heart operation is the exact type of surgery and the patients associated other illnesses. The most recent national results for this service can be found here.
The department of cardiothoracic surgery at MFT is part of
the Manchester Academic Health Sciences centre /http://www.mahsc.ac.uk/. The two main areas of academic interest are in cardiopulmonary transplantation, and clinical outcomes research led by Professor Rajamiyer Venkateswaran.
The Transplant Centre at MFT has a fully equipped research laboratory, which has been open since 1997. Since then we have published numerous articles in peer reviewed journals, and work has been presented at prestigious National and International meetings. We currently have several students working in the laboratory. These consist of MSc, MD, PhD, BSc students from the University of Manchester, Manchester Metropolitan University and the University of Salford.
The North West Heart Centre is located in the Yellow Zone at Wythenshawe Hospital near entrance 6 or 7, off Floats Road.