Cardiothoracic Surgery

The Cardiothoracic Surgery research is translating and evaluating strategies to enhance recovery and reduce the risk of complications after cardiac surgery.

The group is establishing a clinical trials unit (CTU) as a satellite of the UKCRN-registered Imperial CTU. It also has a strong collaboration with the Bristol Heart Institute, bringing together the excellent basic cardiovascular and clinical research experience of the two universities.

Active areas of research are focusing on:

Minimally invasive surgical techniques to reduce the iatrogenic harm caused by surgery. These include carrying out mitral valve surgery through a small right thoracotomy, and obtaining saphenous vein for coronary artery bypass grafting using an endoscopic technique.
Reducing the systemic inflammatory response caused by cardiopulmonary bypass. Research in this area includes a combination of studies to investigate the mechanisms of the inflammatory response, using biomarkers and heart muscle biopsies obtained during surgery, randomised trials of pharmacological interventions and a miniaturised cardiopulmonary bypass system.
Protecting/optimising lung function during and after surgery. Good lung function is a prerequisite for prompt recovery after surgery but may be compromised by cardiopulmonary bypass, post-operative mechanical ventilation or impaired breathing. Two randomised trials, one of an intra-operative intervention and one of a post-ventilation intervention, are being carried out.
Assess the effect of aortic stiffness (aortic rigidity) on post-operative functional outcome and quality of life in patients undergoing aortic valve replacement patients. This work aims to develop novel preoperative tools to stratify elderly patients according to their risk of experiencing a severe post-operative complication.
Aetiology of postoperative atrial fibrillation. This project is using metabonomic and microRNA analysis in patients undergoing coronary artery bypass grafting.

We have extensive collaborations with other groups within and outside the NHLI, including participation in NIHR portfolio trials.