Magdi Yacoub on his life at the cutting edge of heart surgery
Knighted for services to medicine and surgery in 1991, Professor Sir Magdi Yacoub pioneered a number of operations to correct congenital heart conditions, and improve heart transplant surgery, and was the first BHF Professor of Cardiothoracic Surgery.
What part has the BHF played in your career?
I started as a practising cardiac surgeon, doing clinical research looking at the results of certain operations. Early on, I realised the BHF was interested in research and could help with funding some of these studies. I was asked to consider joining the National Heart and Lung Institute as the first professor of cardiothoracic surgery.
Why decide to conduct research as well as perform heart surgery?
I had an innate desire to know new things, to perfect what we were doing, to evaluate new forms of treatment and to study and improve surgical techniques.
We were swamped, and we couldn’t cope with what was going on, but we also found that cardiac surgery provided material for studying the basic elements of cardiovascular disease. We saw that we could prevent disease as well as treat it, and if we put ourselves out of a job, great – really, you felt if you could do that, you could go and grow oranges and be very happy.
You’ve achieved so much, what are you most proud of?
I don’t want to slow down, because it’s a way of life, it’s something I enjoy
I have children and grandchildren and if you asked me who my favourite child is, I would say I love them all. I feel the same about my research.
So is it operations for children with congenital heart disease? Yes, of course. Is it new methods in transplantation and immunosuppressants, seeing people survive longer? Of course. Is it tissue engineering and the regenerative therapy? Of course. But it’s all related and to pick on one of them and say ‘this is my favourite’... I am not going to do it.
What challenges remain?
Seeing people of all ages come down with severe heart failure, and seeing them die unless you do drastic things such as give them a heart transplant or artificial hearts... We really have to discover what causes that at a molecular level.
For example, if you put left ventricular assist devices [devices used to support a failing heart] into patients, you show so-called terminal heart failure is slowing. It’s very, very exciting to think ‘is that going to lead us to finding something reproducible to reverse heart failure and to stop people dying?’ That’s something I would love to see before I die.
How confident are you of seeing a cure for heart failure?
Some of the results in the lab have been quite promising using stem cells but it has to be done in animal models and in the clinic but in extremely controlled conditions and this is not to say to the public that we have a cure for heart failure.
How long we are going to take depends on how much investment you put in it; there are keen people, young people and old people like me, who will work day and night to bring it sooner rather than later but they require material. I would say to the public it will come in three to ten years depending on how generous the public is.
I understand you also have an interest in cardiomyopathy...
Yes. What’s so exciting is getting to see how the heart formed in the first place, the molecules that are responsible, and what goes wrong to produce congenital heart disease. I am very interested in inherited heart muscle disease – cardiomyopathies – in all its forms, the dilated, the hypertrophic, the arrhythmogenic.
We began by describing what we saw in structure, and changes in function. A lot of it is inherited, so there has to be a genetic mechanism behind it, and that stimulated more research. Now we know more than 100 genes are responsible for the different types [of cardiomyopathy].
The next thing is to understand how the genetic abnormalities translate into the disease and then treat it or prevent it molecularly.
Tell us about your charity, Chain of Hope
When I finished my training, I used to go out to Egypt with colleagues I met during my training and help them treat children with heart conditions. Heart surgery was just starting then but it was not available across the world. Then we went to South America and to Africa as a group of two of three. We realised we needed a sustainable organisation, which will survive me and so I established Chain of Hope UK.
To find something reproducible to reverse heart failure and to stop people dying....is something I would love to see before I die
We have networks now, we know almost everybody around the world. That’s what chain of hope does – around the world including the countries that need it. We work with them to create a sustainable service. In Aswan, Egypt for example, the unit performs all types of operations on small babies, new-borns, the switch operation, by local staff, day and night free-of-charge.
Plus you’re supervising PhD students…
It’s a very exciting thing to work with students and particularly PhD students and trainees in both these countries and abroad, because I think this is a fantastic legacy to leave behind. I am really happiest when I meet people saying – and it shows my age as well – ‘I went to medical school only because I heard about you’. I think ‘Wow’ – that’s something I cherish.
What do you do when you’re not working?
I have just come back from Vietnam two or three days ago and spent three or four days with my grandchildren, which was the happiest time of my life. I missed out with my children I think; they say that, too, that I was too busy. So now I am trying not to do the same mistake again. It is like magic, it is invigorating, it’s a two-way system again you see the happiness they give you; they seem to greet you with unlimited happiness and love.
Can you ever see yourself retiring?
I do feel tired a lot but I enjoy what I do and I cannot sit on a beach for half an hour without thinking about something and I really get bored. I don’t want to slow down because it’s a way of life, it’s something I enjoy thoroughly and I wake up at 3am thinking about writing a grant to the EU or reading the latest issue of Nature. I am not suffering.