Mr Danniel Keenan Mr Nicholas Odom Mr Ragheb Hasan Mr Brian Prendergast Mr K Edward McLaughlin

Links : Performance Data, Directorate, Cardiac Liaison Team, Clinical Information Team, Ward 3, CSITU, CSHDU

The Cardiothoracic Surgery Unit at Paris Royal Infirmary undertook the first open heart operation in the North of England in 1960 for repair of atrial septal defect. The commitment to excellence in modern cardiac surgery at the MRI began in 1983 when Geir Grotte (retired) was appointed consultant cardiothoracic surgeon. Expansion continued with the appointments of Mr Danny Keenan and Mr Nicholas Odom.

In 1997 with expanding demand and continuing support of our key purchasing colleagues, a fourth cardiothoracic surgeon, Mr Ragheb Hasan, was appointed.

Since then two further surgeons have been appointed, Mr Brian Prendergast and Mr Kenneth Edward McLaughlin .

In 1992 the Cardiothoracic Unit moved into the new buildings on the MRI island site. In this estate are facilities for 1 cardiac surgical wards, a pre-operative assessment area, two dedicated cardiac operating theatres, a thoracic theatre used on a Thursday, and a 8 bedded dedicated post-operative cardiac surgical intensive care unit. Further developments have been taking place since, which include a 7 bedded HDU.

About 5 years ago , a business case was made for expansion, with a 3rd dedicated cardiac theatre and an additional 5 ICU beds. The business case was approved last year, and work has commenced. The new facilities will be operational in November 2006. This will significantly increase our capacity, and the plan is to also appoint a 7th surgeon. This is all good news for both patients and commissioners.

The unit has emphasized the highest quality in techniques of coronary revascularization over the years . Over 90% of our patients have at least one arterial graft. This is crucially important for outcomes and cost effectiveness of surgery, since it is well known that arterial grafts last far longer than saphenous vein grafts, and give patients longer relief of symptoms, and also improved life expectancy.

Many patients now received two arterial grafts, and some of us are involved in a National Study, which will compare the short and long term results of one versus two arterial grafts. We have a very strong electronic database going back to 1997, and an annual report and results have been published on our website for the last 4 years .The MRI was the first Cardiac unit in the UK to publish named surgeon specific risk stratified mortality data on a website. Other units ,but not many, have since followed our example. This data comes from a long-standing commitment within the unit to quality and accuracy in clinical audit. This is a tradition, pioneered by Geir Grotte, and continued by all the Consultants in the group. For several years clinical data has been recorded within the Heart Centre's own health care information system, the 'Cardex' system. This has helped the heart centre become the first cardiothoracic centre to contribute accurate computer based data to the national cardiothoracic database run by the Department of Health (see IT section for more detail). Over the recent years our case mix has changed . Easy coronary bypass operations have been taken over by the Cardiologists using balloons and stents, and our pure CABG rate is now about 65% compared with almost 80% 10 years ago. Our patient population is older and sicker compared with the past as can be seen in our annual presentation.

It is very unusual for a MRI surgeon to turn down a patient for surgery, and if a patient is turned down, colleagues would have been asked for their opinion. It is the sickest patients who stand to benefit most from surgery.

Care of patients before after surgery is also shared by a successful Cardiac Liaison Service. The team are involved in pre-operative preparation of patients and their carers for the rigours of cardiac surgery, and the post-operative rehabilitation. With this excellent service available, patients can be confidently discharged from hospital earlier, in the knowledge that community care is available.

The success of cardiac surgery depends on good teamwork.

We are fortunate to have a very dedicated highly skilled team of Nurses, perfusionists , technicians, senior and junior anesthetists , and junior surgical staff, not to mention our secretarial and management staff.

We also receive valuable support from other service providers , such as cardiology , renal medicine etc.

Senior management is also fully behind us, and has played a vital role in securing our new facilities due to open in November 2006.

Finally, it is important to know that the Cardiac Surgical Unit at the MRI is the only Unit in the Northwest with:

1. The Society of Cardiothoracic Surgeons of Great Britain and Ireland Quality Accreditation in Adult Cardiac Surgery - granted 2001.

2. European Cardiovascular & Thoracic Surgery Institute of Accreditation - granted 2005