Dr Levi Bassin – Improving outcomes in Coronary artery bypass surgery
Coronary artery disease represents an enormous burden of disease in the general population which has resulted in coronary artery bypass surgery evolving into one of the most commonly performed surgical procedures globally. However, because of its success, it remains largely unchanged from when it began 40 years ago.
This surgical procedure usually involves bypassing vessels on the surface of the heart, which have significant narrowing. By grafting new arteries or veins onto these blocked ones, a new blood flow is created to the heart to reduce the risk of Heart attack, angina and improve survival rates.
The most commonly used grafts are the Internal Mammary Artery (or IMA), which can be found behind the chest wall, or in veins from the leg. While this procedure is effective and durable for complex coronary artery disease, there can still be a significant proportion of patients, up to 10%, whose grafts fail in the first year following the operation, meaning patients have to undergo further treatment.
Practicing cardiothoracic surgeon, Dr Levi Bassin, has received funding from Heart Research Australia for a project which essentially looks at ways to improve this life-saving procedure. Dr Bassin and his team are undertaking a randomised study over the next 2 years, of over 140 patients who are undergoing coronary artery bypass surgery at Royal North Shore Hospital. They will compare how open their grafts are after 1, 5, and 10 years and if this correlates to whether the graft is placed off the aorta vs off an IMA. They will also be assessing the flow characteristics within the arteries at the time of surgery, by using transit time flow measurement (TTFM). This uses ultrasound technology to assess the blood flow and flow characteristics through a coronary artery bypass graft at the time of surgery. Dr Bassin’s team is planning to gather this data and to follow these patients over the longer term to establish whether there were any signs at the time of surgery which would indicate future graft failure.
It is hoping this trial will change the way coronary bypass surgery is done in the future by reducing graft failure and therefore the need for subsequent therapy.
This trial will also have the added benefit of involving and attracting new, young academics to cardiothoracic surgery, improving their knowledge and helping them to be better surgeons.
To read more about the research Heart Research Australia is funding click here.