Anniversary of First Open Heart Surgery in NZ

Friday 19 September

ADHB Celebrates 50th Anniver sary of First Open Heart Surgery in NZ

This year marks the 50th anniversary of New Zealand's first successful open heart surgery. This procedure made NZ history in 1958 and is performed almost routinely today.

Sir Brian Barratt-Boyes commenced his pathway to fame in 1958 when he operated on Helen Harris (nee Arnold), now 59 at the then Green Lane Hospital, using an imported Melrose Heart-Lung machine. He led a team that was at the forefront of heart surgery and pioneered a new surgical era that allowed the correction of heart defects that were hitherto untreatable.

Helen Harris's heart defect restricted her from normal physical activity.

"Before the surgery, my parents didn't molly-coddle me, but I was always the one who got caught playing games, being the slowest. Sometimes I would fall asleep under our table. I was very sick just before the operation and my parents were told I wouldn't survive. The surgery opened the door to a new life," says Helen Harris.

The procedure involved closing a hole, present since birth, between the two main pumping chambers.

Sid Yarrow was the technical perfusion specialist in Barrett-Boyes' team and was involved in assembling the Melrose machine used in Helen Harris' operation.

"Those were the best days of my life. It was hard work, dedication and passion of many people that made this possible. I remember working long hours to ensure that we had looked into every detail," he says.

Surgeons in the Green Lane Cardiothoracic Unit at Auckland City Hospital (ACH) still continue to build on the success of Sir Brian Barrett- Boyes.

"We've come a long way since that first heart operation by Sir Brian Barrett-Boyes in 1958. We estimate that over 2500 open heart surgeries are undertaken in NZ and over one million open heart operations are done in the world each year. Sir Brian was one of the doyens of cardiac surgery who pioneered techniques in cardiac surgery that made it possible to safely achieve the volume that takes place today.

Amongst his many innovations, he is most remembered his technique of implanting homograft valves plus developing and popularising hypothermia and circulatory arrest. In addition, as a scientist, he participated and assisted in the development of rigorous statistical analysis of surgical outcomes in close association with his mentor John Kirklin and Eugene Blackstone," says Mr Paget Milsom, Clinical Director, Green Lane Cardiothoracic Unit, Auckland City Hospital.

Members of the unit have been instrumental in introducing techniques from abroad including: arrhythmia surgery, cardiac and lung transplantation, a left ventricular assist device programme and endoluminal stenting of the aorta.

"In addition the Service has continued to produce novel technologies including: C-pulse (an extra-aortic counter pulsation device which assists cardiac output and coronary flow), the Dual Vent Circuit (which reduces emboli to the brain after open heart surgery and as a result reduces brain damage), the Safer Sleep system (which reduces drug administration error during anaesthesia). These devices are currently undergoing scientific evaluation within New Zealand and overseas," says Paget.

Kirsten Finucane has been a Paediatric and Congenital Cardiac Surgeon in Auckland for 12 years, first at Green Lane then at Starship Children's Health at ACH. She has seen a steady improvement in survival and long term outcomes for infants, children and adults undergoing repair of congenital lesions. Improvements in technology have allowed longer and more complex repairs on tiny newborns or very complex infants with excellent chances of survival and avoidance of complications such as brain injury or the need for reoperations.

"Better protection of the heart whilst on bypass and detailed intra operative echo technology has also allowed for longer and more ambitious valve repairs thus avoiding the need for valve replacements in children and teenagers with rheumatic valve disease or congenital valve lesions.

"New and sophisticated methods of postoperative mechanical support (such as Extra Corporeal Membrane Oxygenation (ECMO) and Left Ventricular Assistance Device (LVAD)) after cardiac surgery have helped to rescue some infants and children who otherwise may have succumbed to early problems and has allowed many to recover fully with excellent long term outcomes," she says.

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