Manchester Heart Centre

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Cardiothoracic Surgery Unit
Links, Consultants, Contacts, MHC Directorate

The Cardiothoracic Surgery Unit at Manchester 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 and the MRI began in 1983 when Geir Grotte was appointed consultant cardiothoracic surgeon. Expansion continued with the appointments of Mr Danny Keenan and Mr Nicholas Odom.

The number of CABG has increased steadily over the last 10 years. We are preparing plans for expansion to 1250 cases a year within two years. In 1997 with expanding demand and continuing support of our key purchasing colleagues, a fourth cardiothoracic surgeon, Mr Raghab Hasan, was appointed.

In 1992 the Cardiothoracic Unit moved into the new buildings on the MRI island site. In this estate are facilities for 2 cardiac surgical wards, a pre-operative assessment area, to dedicated cardiothoracic operating theatres, a thoracic theatre and a dedicated post-operative cardiac surgical intensive care unit.

The unit has emphasised the highest quality in techniques of coronary revascularisation. This exemplifies by a very high rate of bypass grafts per case, (average 5.7), reflecting the well-known beneficial effects on outcome of cardiac surgery of 'complete revascularisation'. Our group has also determined that arterial grafting should be strongly emphasised, and almost 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 aterial grafts last far longer than saphenous venous grafts.

Many patients now received two or even three arterial grafts in a CABG procedure. Recently we have reviewed our results of cardiac surgery in patients over 70 years of age. Our mortality outcomes are as good in this group as mortality outcomes for all operations in the UK. Mortality in the UK for patients over 70 years of age is twice that seen in the Manchestester Royal Series of over over 500 patients between 1988 and 1997. 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, particularly Mr Rahgeb, who has a special interest in clinical audit. Mr Hasan and the other consultants are supported by a full-time audit clerk. For the last 6 months clinical data have 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).


In recent years the Unit has avidly embraced new approaches to coronary bypass grafting. This includes the minimally invasive approaches, or MID-CAB. Recently Mr Danny Keenan presented the results of minimally invasive bypass grafting in 30 patients in the research sessions at the British Cardiac Society in Glasgow. These new approaches hold out great promise of a marked reduction in morbidity and costs for some patients with specific patterns of disease. Often patients can have their operation through a tiny incision in the chest without the need for an open heart procedure using a heart and lung machine. Some patients complete their hospital recovery and are discharged home within 3 days. The consultant staff are well supported by five junior and senior surgical trainees. Care of patients 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.

Contacts

Name Role Ext Email Bleep Mobile Fax
Mr B. Prendergast Cardiac Surgeon 5962brian.prendergast@cmmc.nhs.uk
Mr D. J.M. Keenan Cardiac Surgeon 8521daniel.keenan@cmmc.nhs.uk 8522
Mr G. J. Grotte Cardiac Surgeon 4271geir.grotte@cmmc.nhs.uk
Mr R.I.R. Hasan Cardiac Surgeon 8907ragheb.hasan@cmmc.nhs.uk

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Manchester Heart Centre IT
E-Mail: help@cmmc.nhs.uk
Web Address: http://www.manchesterheartcentre.org

Mr Brian Prendergast


Mr Danny Keenan


Mr Geir Grotte


Mr Nicholas Odom


Mr Raghab Hasan